Laserfiche WebLink
f <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE- STOCKTON CA 95205 - (209) 468-3420 <br />NON-REFUNDABLE PERMIT GALL (ZU&)'J53-/6y/ FOR INSPECTIONS <br />JOB ADDRESS 13389 East Live Oak Road Cmr%11P Lodi 95240 <br />CROSS STREET Jack Tone Road <br />OWNER NAME Freddy Diaz <br />APN 063-280-080-000 PARCEL SIZE 3.140 acres <br />P14nNE(209)810-5731 <br />OWNER ADDRESS 13389 East Live Oak Road Cm/STATE/ZIP Lodi CA 95240 <br />CONTRACTOR AdvancedGeo,Inc. PHONE 800 511-9300 <br />CONTRACTOR ADDRESS 837 North Shaw Road -CITY/STATE/ZIP Stockton, CA 95215 <br />Supervised by 13:1C-429 8574 "^ ` telk� 1/31123 <br />LICENSE 13:1C-42 0--C-36 OTHERCA Professional Geolo iNUMBER +v+ EXPIRATION DATE <br />D <br />WATER TABLE DEPTH: 130-140 ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br />® PERC TEST # 1 BUILDING PERMIT # LAND USE APPLICATION # <br />TYPE OF WORK: ❑ NEW INSTALLATION ❑ REPAIR/ADDITION ❑ ENGINEER DESIGNED /ALTERNATIVE <br />❑ REPLACEMENT U OUT -OF -SERVICE SEPTIC SYSTEM ❑ DESTRUCTION <br />INSTALLATION WILL SERVE: ❑ RESIDENCE ❑ COMMERCIAL ❑ OTHER <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br />❑ SEPTIC TANK TYPE/MFG CAPACITY gal # OF COMPARTMENTS <br />❑ GREASE TRAP TYPE/MFG CAPACITY gal # OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL ft FOUNDATION it PROPERTY LINE ft <br />❑ LIFT STATION SIZE TYPE OF PUMP O PKG TX PLANT O SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />❑ LEACH LINES D LEACHING CHAMBERS,_. <br />#OF LINES <br />LENGTH OF LINES ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ FILTER BED WIDTH <br />it LENGTH <br />ft DEPTH it <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE it <br />❑ MOUNDED WIDTH <br />It LENGTH <br />ft DEPTH it <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTYLINE it <br />❑ SUMPS WIDTH <br />it LENGTH <br />ft DEPTH it <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />it PROPERTY LINE ft <br />❑ DISPOSAL PONDS WIDTH <br />ft LENGTH <br />ft DEPTH ft <br />DISTANCE TO NEAREST <br />WELL <br />_ ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ SEEPAGE PITS NUMBER <br />WIDTH_ <br />It DEPTH It <br />DISTANCE TO NEAREST <br />WELL <br />It FOUNDATION <br />it PROPERTYLINE ft <br />I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND <br />THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br />STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br />MINIMUM 48 HOUR ADVANCE NOTICE <br />REQUIRED <br />FOR INSPECTIONS - PLEASE CALL (209) 953-7697 <br />O <br />O <br />F <br />DEPARTMENT USE ONLY <br />Application Accepted By Date Area Employee ID# ftin G <br />Final Inspection By Date 4 -C—D SPECIAL PERMIT - Approved by <br />Character of Soil to Deptl of 3 Ft: PIVSump Soil Character: <br />COMMENTS '- tk4L-w M&Ta Sl 2.7-i wa)ivt, aJ-r-j 1L <br />PE SC Received ChecklU <br />Amount Date Permit/ Invoice # Permit ID# <br />Code INFO <br />Remitted e i # <br />yaa a S;? 3 <br />/,.;-4 <br />42-01 l 2- I v ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4/14/18 <br />