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SU0004364_SSNL
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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8215
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2600 - Land Use Program
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PA-0200019
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SU0004364_SSNL
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Entry Properties
Last modified
11/19/2024 3:46:24 PM
Creation date
9/9/2019 10:27:33 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0004364
PE
2632
FACILITY_NAME
PA-0200019
STREET_NUMBER
8215
Direction
E
STREET_NAME
STATE ROUTE 12
City
LODI
ENTERED_DATE
5/17/2004 12:00:00 AM
SITE_LOCATION
8215 E HWY 12
RECEIVED_DATE
1/22/2002 12:00:00 AM
QC Status
Approved
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SJGOV\sballwahn
Supplemental fields
FilePath
\MIGRATIONS\T\HWY 12\8215\PA-0200019\SU0004364\NL STDY.PDF
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EHD - Public
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LIQUID WASTE PERMIT <br /> SAN JOAQUIN COUNTY' 'HEALTH SERVICES ENVIRONMENTAL HEALTH DWUSION <br /> R c ( IME.WERE-FLOOR BTOCTLTON.CA 93202(M)WLMTO <br /> `H18ADDRESS $Z15 4. J� f' I�FUND.1/�O ;EPERMIT EXPIRES <ipFROM C3C DATE IRS <br /> �L.. . PARCEL SR2: I�•I� <br /> CTTYMP Uk ( .LAI BUILDING PERMIT <br /> �1CP VT 1 C�12N C.V l �C� ADDRE53�' I YYI�l�P .r✓/1 i1GCL -\ Lf�• - . <br /> OWNGNAMC /1 L - <br /> ' Q L,'4L[ �'� S PHONE HUMBER Q7cpo c1e1-3- 1114 ` <br /> CRYZP <br /> rnrmuR /T� nn <br /> 1C4' lJ 'L.V�4 - HCC( . ADDRrADDRESS <br /> R. <br /> CITYD:H I l^C� JX�O PRONE NUMBER <br /> GEOGRAPHICAL INFORMATION:COORDINATE&X Y TOWNSHIP�RANCE_SECTWN <br /> ME OF SEPTIC WORK: INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS:_ <br /> ❑ NEW INSTALLATION O RESIDENCE NUMBER OF BEDROOMS:'.:. <br /> O REPAIRIADDITWN O COMMERCIAL "MIDEROFEMPLOYEES: <br /> ❑ DESTRUCTION ❑ OTHER <br /> ❑ ENOMEEREDIALTERNATIVE <br /> CHARACTER OF SOIL TO DEPTH OF 3% PIT/SUMP SOIL CHARACTER: (: WATE R TABLE DEP TH'. <br /> M <br /> F✓Y <br /> PON:TEST is) HOWANY I APPLICATION p PA-0-auMIS <br /> ❑ SEPTIC TANK TYPEYMFG CAPACITY #OFCOMPARTMENTS <br /> ❑ GRLA9[TRAPTYPFlMFG CAPACITY O OF COMPARTMENTS_ <br /> ❑ PxcrS P.IAMT DISTANCETONEAREST: WELL Fp ATION PBOPER,L,NE <br /> ❑ LIFTSTATON SIZE TYPEDFPUMP SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINE *OFUNES: LENGTHOFLINES: pIn,INttTDxuunT: WELL PYUNDAMN' PROPEFTY LME_ <br /> INFUTRATOR CHAMBERS m <br /> r O FILTER BLD W..— LEN(HH— DE91N_ A IEMxum <br /> v : WELL POIINDATION_ PSOPERn LME_ i,.,1 <br /> ❑ MOUNDED- WIDTH— IENOTx_ .DEPTH— OLnTµcl TV...m:. WELL_ T,,NDAMN� PROPRW LINE_ <br /> O SUMPS WIDTM— LENGIH DRTN DaT x WELL_ F MATpM-L-.-- MOPRTY LINE <br /> ❑ DISPOSAL PONDS '-DTH— IENOTN_ DVTN-- YYFu`CINn[.P[n. WELI LINE— <br /> ❑ SERFAGE PRS F P!R^NCITON[.A6r. WELL— FDUNDATHW.— —..TY LME^_ <br /> I HEREBY CERT(%THAT I MVE PREPARED THIS APPLICATION I'D THE WORK WILL BE DONE IN ACCORDANCE WITH BAN JOAQUIN COUNTY ORDINANCES STATE IAWd AND RULES AND REGULATIONS OF US JOAQUIN COVN- _ <br /> MIN MUMUNOURADVANCENOTICE gEQUIRED FOR INSPECTIONS-PLEASE CALL(209)A6 23 N - <br /> slcneo: (.� lib'C�lAVit"P DATE_ <br /> TS N <br /> .3l <br /> ,z <br /> - <br /> � a I <br /> t,a <br /> I <br /> 1L�7 <br /> Wi <br /> DEPARTMENT USE TLY "�; `'A ,*') <br /> AP ION ACCEPTPD BY ^�� -DATE -"�j�2 .FCAEMP[O ENM DBTDIR IOCATW� <br /> INAECIFDBY DATE PTRMIT HNALO YESDAT5: IN$PECTOR'. <br /> CDMMENIS: <br /> Pl&OCE KIXEO RFMIn TD EIXM N 0.TL[E`YED D.TE PE0.MR5EPVKE 0.EpVEti[' INVOIC U. $EPTK Id <br /> ¢Zzz 5Z! 8I a7 ShC030 6 48 <br /> Rcvuoi.lsPl <br />
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