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SR0081371 SSNL
Environmental Health - Public
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2600 - Land Use Program
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SR0081371 SSNL
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Entry Properties
Last modified
1/23/2020 10:25:33 AM
Creation date
1/23/2020 10:14:53 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0081371
PE
2602
STREET_NUMBER
228
STREET_NAME
KLO
City
LATHROP
Zip
95330
APN
19124018
ENTERED_DATE
11/5/2019 12:00:00 AM
SITE_LOCATION
228 KLO
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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foA� ,geS -ry �rupc)ry <br /> ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1968 E-HAZELTON AVENUE-STOCKTON CA 95205-(209)46"20 <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> Jon ADDRESS 228 KID Road Crryop Lathrop,95330 v <br /> CROSS STREET Manthey Road APN 191-240.1131'" PARCEL SIZE 1.61 <br /> OWNER NAME Javier Leon PHONE 209 923-7496 <br /> OWNER ADDRESS 484 Peslana Avenue CITYISTATEop Manteca,CA,95336 <br /> CONTRACTOR Advanced GeOEnvironmental,Inc.(AGE) PHONE(800)511-9300 <br /> CONTRACTOR ADDRESS 837 N Shaw Road CrrY/STATEfZIP Stockton.CN 95215 <br /> LICENSE 0_C-02 ❑_C-36 OTHERC-57/A-Haz NUMBER 680227 EXPIRATION DATE II/30119 <br /> WATER TABLE DEPTH:19M —20 ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> 0 PERC TEST #1 BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: _ NEW INSTALLATION _ REPMRIADDITION _ ENGINEER DESIGNED/ALTERNATIVE <br /> REPLACEMENT OUT-OF-SERVICE SEPRC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: ❑ RESIDENCE ❑ COMMERCIAL ❑ OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> ❑ SEPTIC TANK TYPEIMFG CAPACITY gal #OF COMPARTMENTS <br /> ❑ GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL R FOUNDATION A PROPERTY LINE ft <br /> ❑ LIFTSTATION SIZE TYPE OF PUMP ❑ PKG TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES C LEACHING CHAMBERS #OF LINES LENGTH OF LINES ft <br /> DISTANCE TO NEAREST WELL R FOUNDATION ft PROPERTY UNE R <br /> ❑ FILTER BED WIDTH It LENGTH R DEPTH R <br /> DISTANCE TO NEAREST WELL R FOUNDATION R PROPERTY UNE R <br /> ❑ MOUNDED WIDTH ft LENGTH It DEPTH R <br /> DISTANCE TO NEAREST WELL R FOUNDATION ft PROPERTY UNE R <br /> ❑ SUMPS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL R FOUNDATION fl PROPERTY UNE R <br /> ❑ DISPOSAL PONDS WIDTH R LENGTH ft DEPTH R <br /> DISTANCE TO NEAREST WELL R FOUNDATION R PROPERTY UNE ft <br /> ❑ SEEPAGE PITS NUMBER WIDTH R DEPTH ft <br /> DISTANCE To NEAREST WELL R FOUNDATION ft PROPERTY UNE R <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND 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 PZUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL 209 953-7697 <br /> SIGNED TITLE Senior Geologist DATE 03 October 2019 <br /> Nr <br /> 4 <br /> I Ft <br /> LLL <br /> pEPARTMEVT USS ON Y /�_ <br /> Application Accepted By Dale 0 %CIAL <br /> Employee ID#�_ <br /> Final Inspection By Date T-Approved by <br /> Character of Sall to Depth of Ft PIUSump Sell Character: <br /> COMMENTS <br /> PE SC Received Amount Date Permw Invoice# Permit ID# <br /> Code INFO By Cash Remlited Service Re uest# <br /> 0 Iasi <br /> 42-11 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14/16 <br />
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