Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)4683420 <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS 20679 Highway 120 CITY/ZIP Escalon,95320 ti <br /> rn <br /> CROSS STREET Van Allen Road APN 205-08-004 PARCEL SIZE-47 acres o <br /> •�,�rrte�.� /1��� 0 <br /> OWNER NAME Latitude 37 Partners,LLC bra�fL-i-ir.Y PHONE 1209)602-8569 <br /> OWNER ADDRESS 20679 Highway 120 /2-01(30 ;"1V,4tJr CITY/STATE/ZIP Escalon,CA 95320 1,gg .�J <br /> CONTRACTOR Baez Geotechnical Group PHONE 209-602-6569 <br /> CONTRACTOR ADDRESS 2060 Colorado Avenue,Suite B CITY/STATE/ZIP Turlock,C1A�955382 <br /> LICENSE ❑nC-42 ❑EC-38 �THER­ NUMBER 0' EXPIRATION DATE <br /> WATER TABLE DEPTH:_ ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> ❑ PERC TEST # BUILDING PERMIT#PA-1900087 LAND USE APPLICATION#S00012305 <br /> TYPE OF WORK: .. NEW INSTALLATION G REPAIR/ADDITION - ENGINEER DESIGNED/ALTERNATIVE <br /> REPLACEMENT F OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: ❑ RESIDENCE IG COMMERCIAL ❑ OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES:TBD <br /> ❑ SEPTIC TANK TYPE/MFG TBD CAPACITY TBD gal #OF COMPARTMENTS <br /> ❑ GREASE TRAP TYPE/MFG CAPACITY _ gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL it FOUNDATION ft PROPERTY LINE ft <br /> ❑ LIFTSTATION SIZE TYPE OF PUMP ❑ PKGTXPLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES LEACHING CHAMBERS TBD #OF LINES LENGTH OF LINES TBD ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ FILTER BED WIDTH it LENGTH it DEPTH it <br /> DISTANCE TO NEAREST WELL it FOUNDATION it PROPERTY LINE ft <br /> ❑ MOUNDED WIDTH ft LENGTH it DEPTH It <br /> DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTY LINE It <br /> (3 SUMPS WIDTH ft LENGTH it DEPTH R <br /> DISTANCE TO NEAREST WELL fl FOUNDATION it PROPERTY LINE it <br /> ❑ DISPOSAL PONDS WIDTH it LENGTH it DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE it <br /> ❑ SEEPAGE PITS NUMBER WIDTH It DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <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 g8 HOUR ADVANCE NOTICE FOR INSPECTIONS 953-769 <br /> SIGNED <br /> 5 - <br /> SIGNED TITLE Stefanie Parman,Project Engineer DATE 11/6/19 <br /> RP!4)'4fjiV <br /> Moll <br /> V,/O, <br /> Q��� Zo,9 <br /> Al rN�FAgR�UN�' <br /> FNp <br /> -D A R T M E T N Y <br /> Application Accepted By Date Area Employee IDN <br /> Final Inspection By Date ❑ SPECIAL PERMIT-Approved by <br /> Character of Soil to Depth of 3 Ft: Pit/Sump Soil Character: <br /> COMMENTS <br /> PE Sc I Received Check#/ Amount D to Permit/ Invoice# Permit ID# <br /> Code INFO ash mitt Service Request# <br /> WRA j-56— Q <br /> 421-01 4/19 M1671S ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />