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79-521
EnvironmentalHealth
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CAREY
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8626
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4200/4300 - Liquid Waste/Water Well Permits
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79-521
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Entry Properties
Last modified
6/25/2019 10:39:19 PM
Creation date
12/4/2017 4:27:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
79-521
PE
4211
STREET_NUMBER
8626
STREET_NAME
CAREY
STREET_TYPE
CT
City
STOCKTON
SITE_LOCATION
8626 CAREY CT
RECEIVED_DATE
06/18/1979
P_LOCATION
CAREY DEV CO
Supplemental fields
FilePath
\MIGRATIONS\C\CAREY\8626\79-521.PDF
QuestysRecordID
1678803
Tags
EHD - Public
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FOR OFFICE USE: <br /> APPLICATION FOR SANFTATION PERMIT <br />' Permit No. . <br /> j :..:....._ ...o : (_}.( _.� �.. ._... .... <br /> 1 4..1.. ....... Date issued _ q <br />! This Permit Expires 1 Y 6•) <br /> Year from Dais Issued •,-' <br /> Application is hereby made to the San Joaquin Isocal Health District for a permit to construct and install the work herein <br /> described.`�This application is made in compliance with County Ordinance No. 549 anti a 4stinR4snd Rggulatlons: <br /> '74- <br /> JOB ADDRESS/LOCATIO ..................•- -- .........--•- <br /> b ............... ...... <br /> Owner's .Name ....._ -.. - . .. ... ....... - •=-•-•• .--•..._...-...•-•--•...-••-_. Phone ........ .................. <br /> Address ----_---.. <br /> ....__..... _ ..... City ....... .......•..... ..._....-•..............All <br /> .__ •__-._•-_..._. <br /> Contractor's Name .._._ <br /> License.- -- Phone . .'��• <br /> Installation will serve: Residence©Apartment Houseo Commercial OTrailer Court 0 <br /> Motel Q Other <br /> Number of living units:...... ... Number of bedroo rbage Grinder Lot Size ............... <br /> Water Supply: Public System and name --.. <br /> - ...... .. ..... ,Private <br /> Character of soil too depth of 3 feet: Sand❑ Silto Clay ❑ Peat{] Sandy Loam ❑ Clay Loam ❑ <br /> E t <br /> Hardpan 0 Adore❑ Fill Material .............If yes,type i t <br /> I (Piot plan, showing size of lot, location of system in relation to wells, buildings, etc. must-be placed on reverser side.) <br /> NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) r� f <br /> PACKAGE TREATMENT [ SEPTIC TANK[ ] Size.. - Liquid Dth <br /> ,.._.-on� - <br /> --740Typo Capacity Material.. <br /> _ .----- No. Compartments <br /> - <br /> ~ <br /> Distance,to nearest: Well _1--- ................Foundation ._.-L•1 .......... Prosp. Line ---0.........------ <br /> LEACHING LINE [ ] No. of Lines .._ Len th of each line.._- ' <br /> --• g .. Total Length /..Jro.................. <br /> 'D' Box.;f�ype .filter Material ... <br /> tundation <br /> ...D pth .Filter- Material _ _ --_---•____________________ a�lr tDistance o nearest: Well ........................ .._._....,_..__-........ Property Line ................. <br /> SEEPAGE PIT [ j Depth -- ..� Diameter ��. . Number . <br /> --- -........ Rock Filled Yes No <br /> • r- Water Table Depth ---------- ...................................Rock Size <br /> Distance to nearest: Wel! -6.1-0.. .. ....found tion .... Prop. Line -•------•-•---....... <br /> I <br /> REPAIR/A©t]#TION(prev. Sanitation Permit# -Date _ <br /> •---••------• .......... <br /> Septic Tank (Specify Requirements) ------------ _..- = . .:.. t-' •• ... __..., ......_..._....._.:. <br /> Disposal .Field (Specify Requirements) � <br /> _.. <br /> -� I . ' <br /> -_----••............. ��.. �. <br /> X` r' <br /> ..................... <br /> {Draw existing and required additionLon reverse side) ' <br /> r <br /> I hereby certify that Iyhave-prepared-this,-application and that the work will be done in accordance with San Joaquin <br /> County Ordinances, State Laws, and Rules and Regulations of the Soar Joaquin Local Health:District. Horne owner or licen- <br /> sed agents signature certifies the following: r' <br /> '1 certify that in the performance of the work for which this-permit Is is ed, I &hail not employ any porion in such manner <br /> n' E <br /> as to become subject to Workmas-Compensation laws of California." <br /> Signed ........... -- -------- <br /> sy ---- <br /> ---------- _.. a <br /> (If o . er hen wne Dt :. --•---- ------------------•--- --••------ <br /> - � <br /> FORS PARTMEN USE ONLY <br /> APPLICATION., TEB—BYE ------ --- . . l4""'-. ---............. ............. ...... .., QATE .. �$ _._ ------ ----------- <br /> ILDING PERMIT ISSUED -------=-------------•---•--- DATE -------....._._._ <br /> - ----•--•-.._..--•------------•--••- ---------------- -------- � <br /> ADDITIONAL COMMENTS ..................... E <br /> --------------- •-------- - -- ; <br /> --------------------- <br /> Final Inspection by: ,..t , i k <br /> - � 6.. : . <br /> ... °.......:........ ............... --...Date:.'._. <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT 8/7h 3M <br /> i <br />
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