Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JC412UI4 COUti'1 ENJIRCNIAENTAL HEALTH DEPARTMENT Idfl® E. HA2Ei7o% AYENJE • Srccvioh CA "205 • (2091 466.3A2d <br />NON-REFUNDABLE PERMIT CALL (209) 953-7697FOR INSPECTlONS— EXPIRES 1 YEAR FROM DATE ISSUED <br />.Roe ADDRess 92< Well highway Highway 12 - CEtYlbP Lodi' CA <br />CRoss STREET Gtlard Road APN C5$-07421 PARCEL Sag :'43 <br />OANER NAME Stever Rim - _ _.. PHONE (2WI 423-3220 <br />Or+1eR AOoaess PO Box 942 _-_C".,STATE.ZIP VICW, CA 95240 -- <br />CONTRACTOR Tcrracon COrsuNantsrAaron "cordo PHONE 209.367.3701 <br />COWMACTo l ADaaen 902 IndLISDIaI WSY - Cffv.SjArF,2v LOdirCAM5240 .^�,. ...._ <br />LICENSE .. C-42 I 1 _C -3e OTHER PE NuNE£R 7:446 EXPIRATION DATE 022 <br />WATER TABLE DEPTH: R GECORAPH+CAL INFORMATION: CDOrdinsles X Y <br />X PERC TEST B Z _ BUILDING PERMIT # _ LAND USE APPLICATION III <br />TYPE Of WORK: NEW INSTALLATION REPAWAoamoN ENGINEER DESIGNED IALTERNATNE <br />REPLACEMENT OUT-0E-SMIE SEFTIG SYSTEM DESTRUCTION <br />INSTALLATION WILL SERVE: RESIDENCE 7 CONMEROAL _ OTHER <br />NUMnrR or L'VNG UWTS: NWRER or SF CRomm NUYNERa Ewtayn <br />❑ SEPTIC TANK TYPVMFG _ __- <br />❑ GREASETRAP TvPf'Wc. <br />Mama To Nitmm. WRI. <br />❑ LIFT STATION SBE TYPE OF PUMP <br />CAPA crry gal 80P C.7/APA=TLIEN7,S <br />CAPACJTY _ gal If OF CwYAFA-TLrEr1: s <br />11 F:I"A71C.N It PR]PF.RTYLhE R <br />.0 PKO TIT PLANT O SAND OIL SEPARATOR (ENCLOSED SYST04 <br />❑ LEACHLINES <br />LEACHINGCHANBERS <br />0DFLINES <br />LENGT)IDrLINES _ _ _ _ R <br />_ <br />DISTANCE TO NEAREST <br />'NFL. <br />N FOLNDATICN <br />It FRCPERTYUNE <br />❑ FILTER BED <br />Wvnl _ -_— <br />R LFHOTH <br />11 <br />DEPT' <br />DISTANCE TO NEAREST <br />WELL <br />t: I0Lhumir)H <br />N Pnr:m"IINF R <br />❑ MOUNDED <br />7YDrH <br />R LENGTH <br />0 <br />Dorm. R <br />DI$r4NGET0 HE AAEST <br />'HELL <br />N F?LNDAnON <br />R mrrrn7Y tow R <br />❑ SUMPS <br />wurH <br />r LENSTN ._.... <br />R <br />DEPT. R <br />DISTANCE TO NEAREST <br />WELL <br />d F0UNDAnCN <br />11 PRCPER"UNE - R <br />❑ DISPOSAL PONDS <br />WEnI ._ <br />R LENGTH <br />_ It <br />DEPT. - R <br />DISTANCE TO NEAREST <br />'HELL <br />_ 1: F"OATK:N— .__ <br />N PnCPFR1y►INP. __.__—_ R <br />❑ SEEPAGE PITS <br />NuluetA <br />WDFN _ <br />r DEPT • _ _ - _ R <br />DI':'AIILk 10 NE AAE4T <br />v:Fl, <br />h F��r10ATICN <br />11 FRCFg�YJNE R <br />-EREBY C£R':FYTHAT I HAVE PREPAREC TMS APPLICA'10N A140 THE WORK WILL eE DOAL IN ACCORDANCE WITH SAN JOAOUIN COUNT/ ORDINANCES, <br />STATE LAWS <br />AND RULES AND <br />REGULATIONS OFSAN JOAQUIN COUNTY <br />NINIMUM48 <br />HOUR ADVANCE NOTICE <br />REQUIRED <br />FOR INSPEC77ONS - <br />PLEASE CALL (209J 9517697 <br />":-""',:;: <br />IITLE Sta-1 Scientist <br />DATE Aorl 13, 2021 <br />SIGNED WaWs Tama'a <br />A OEPA <br />X77 R7Mfe!„1LZ Q <br />AppliCatlon Accepted By --.�—�(4IS 'Z Arfla y • Frrpi^yne IDS )VA <br />rirul Inspection By - - ----- --- Date — _-- - ❑ SPECIAL PERUR - AFprovfid Of <br />Character of Soil to Depth or 3 FI _ _ PlbSurRp Boll Character, <br />COMMENTS — --- <br />PE I 5CF1,11.1-11Code IIfFID <br />:hcckjs� AmountUA a pM^gE <br />�4 h HeaniMM i Service R uest IT <br />bYDlce B <br />PerTnll tt7iY <br />rt 3OL <br />_ <br />42411 045."EWAS:E'NATEnT17VIN SYSTI'MPFR)A,T <br />4'14.78 IZ379 73q1eDc7 <br />