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SU0011183
Environmental Health - Public
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EHD Program Facility Records by Street Name
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12 (STATE ROUTE 12)
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2600 - Land Use Program
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PA-1600179
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SU0011183
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Entry Properties
Last modified
11/19/2024 3:48:16 PM
Creation date
9/9/2019 10:27:24 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0011183
PE
2631
FACILITY_NAME
PA-1600179
STREET_NUMBER
7871
Direction
E
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240-
APN
05135007
ENTERED_DATE
1/13/2017 12:00:00 AM
SITE_LOCATION
7871 E HWY 12
RECEIVED_DATE
1/13/2017 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\T\HWY 12\7871\PA-1600179\SU0011183\APPL.PDF \MIGRATIONS\T\HWY 12\7871\PA-1600179\SU0011183\CDD OK.PDF \MIGRATIONS\T\HWY 12\7871\PA-1600179\SU0011183\EHD COND.PDF \MIGRATIONS\T\HWY 12\7871\PA-1600179\SU0011183\EHD PERM.PDF
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EHD - Public
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APPLICATION FOR LIQUID WASTE PERMIT <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 388, 446 N. SAN JOAQUIN ST,STOCKTON,CA 96201-0388 <br /> (209)4683420 <br /> MN O"MUNSARLE PERMR EXPIRES 1 YEAR FROM SATE ISSUED <br /> Ramp6m in Tr}EmRI <br /> KRICATT04 IF KREOY MADE TO THE SAN MAOUN COUNTY"A PERMIT TO CONSTRUCT 4IpTR INSTALL THE\MRV.DEWMEO, THIS ARMA ATO.IF MAOE IN COI.PINR:E YTTFI SAN <br /> MAOIAN COUNTY CfVODRNRENT TTIL£,CHAPTER 9-1110.3 AND THE ITAMARD.Of BAN AAW IN COUNTY MS.HEALTH 8ERVICE6,ENV W.N ENTAL HMTH O SIGN. <br /> ..AOOKSeNR AP 1 $J 24; CT' Z LOT sum <br /> OWNER'S HA NE r�pyK- /LIT ROORE88 5&/ <br /> � PHONE <br /> CONTRKTDR /ii�4li1/ / / bWE86 2422 L/ � � 110E yrvoy�rFFOK T,(�-f037 <br /> SW COMMCTOOR l AOp1E8S ml qqK <br /> TYPE Of SVTIC WqN: Al.NBT..❑ nBYuUmPor1o. OF/T11UC1pN❑ <br /> WO OPTIC BYSTEY P9VKETED IF R18UC SEWER 18 AVwIMIE WNW H 200 FEET Of SUE D',I EMI.MEW I I MIT YAV <br /> AMNbn I <br /> INSTAWl10M WILL S6R2: IEMpFNCE�COMMNCI.LL 0 OTHER❑ <br /> XIYM OF.0 ImTS:f MNMROFE OMe� MIMYI Of m"Toms, <br /> CHARACTER OF SDI.TO A DFPDI OF JNE M4RAIP SOIL WATER TABLE OfPTN <br /> SFTC TAK/MFYi TRAP E3 TYPENEO CAPACOY 1q,COWARTMFMB <br /> RM TKATYENT PLANT❑ gSTAME TO MEARST: wLLja� ;pUNOAMNYr ITIpKRTY.1 I <br /> VT V-FION 11 WE TYPE OF PUMP BANG OIL SEPARATOR ENCLABM BYBTFMI /� <br /> LEFEREM UNE E�W.S I.E.Of UM, iA- 7�T MET..TO NEAMT:WEtLIRITEIR TINDATOM ]_PRpPERTV LME <br /> NOUNDW ❑WTpTN tENOTN DEM DISTANCE TO KMER:WEL�z FOUMpAT.. R RERTY UK <br /> YOWO[O R❑r WETTH LERETX DEPEN PRANCE TO NEAREST:HILL FOUMATION P1gPERfY LINE- <br /> :MR. <br /> INE �A <br /> :M R.RTe LIR DEPM�WE�G// NMIM�PBTµ[,TO FEAREST:WpL �//JS IpINpATIOM C� gpFSRTY LM ;/7 O'y <br /> e ❑YNorN tAMTN DEPfH <br /> DISTANCE TO NEAREST:WELL FEUMATXTN AIOIERTY UK <br /> dWSAL PONpS ❑WOTH LENGTM DEPTH IST-ME TO MEAIEST:W ROUND.. RFFO TY LyE <br /> I HERESY CERTIFY THAT I HAVE FREPAPI D THIS IAiICATNIN ANO THAT TK WOR(WRL BE-AE IN ACCOIOANCE I TM SAN AApRN COUNTY OPINFRA IS AM RATE LAM AND MD <br /> ANDRWLNATONSOFTK AL NOTFAICOUNTY.HUMFN W SUCH A MAMO AS <br /> TO MOMS UCFTTO THEFOLLOMN6:-ICFRTIFYT-ATN OF FEMOPINUL' OFTHENEHE SE OR THIS IFAYT m ING SD.I SMALL NOT EMS TH ANY PE M N SUCH w MHAT IN M TO HCOME E OF T E W9RLM A OF CER P RTAUR UWF OF ,I SKANK• COHERACMIIS SUBJECT <br /> M <br /> RORERMA'SCOMONSATIOIL CFRTIfIEFEU RFHp- HE •ICEIANTTIFY THAT INTK RI fOMAµCEOFTHENOR[FORWHCHTMS RNIB MUM, EHALL Ho SEFOMOM SVBJ[CT TO <br /> WOIRMAM'S/CO/M///PEEN/S/A/TJION(U/WS//Of<LKUOIN�IwJ.' THE AIRNIAXTMWT CALL 2A NOIIISNAOVANCE fOII ALL REOLISYD IFSIRTIOm. COMgJTf ORR'MW BELOW. {� <br /> ..HED AI le!: '& / TRI,' <br /> l- DATE <br /> ROT PLAN GNAW TO B AIFI SAIF l <br /> 1. N.frES OF TPEETS OR PO ADb MFA11fR TO OlI EO11NONMi iFF R1ORMv feA. LOCATNN OF MJV6<BEWARE ORM.BYSTfM OR M1OMM <br /> 2. OUfL1NF OfTK FWUPGTY.'MTH DIMFHEIOm RHO MJRTM OM[CTpN. EXPANSION OF BEWARE NBIOBRL SYRRAS. Cl <br /> T. ORAT OFFD OUTWES Arq LOCATOM OF ALL M"W AM PROMSEL STRUCTURES, S. ..M.OF..WRHN RAD OS OE OK HUNORID Im R.ON r <br /> IHCLUENO COWEDN SUCH AS PAM[gFVfWAM AND WALLAS. THE PROPERTY OR bJOWW ROFMTY. <br /> PAYMENT <br /> RECEIVED <br /> APR 2 4 1995 _ <br /> AN JOAQUIN CIc; <br />
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