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7632
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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CARROLL
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4200/4300 - Liquid Waste/Water Well Permits
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7632
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Entry Properties
Last modified
5/5/2019 10:04:07 PM
Creation date
12/4/2017 4:49:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
7632
STREET_NUMBER
32
Direction
S
STREET_NAME
CARROLL
STREET_TYPE
AVE
City
STOCKTON
SITE_LOCATION
32 S CARROLL AVE
RECEIVED_DATE
5/29/1956
P_LOCATION
DOROTHY CHANDLER
Supplemental fields
FilePath
\MIGRATIONS\C\CARROLL\32\7632.PDF
QuestysFileName
7632
QuestysRecordID
1681219
QuestysRecordType
12
Tags
EHD - Public
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APPLICATION FOR SANITATION PERMIT Permit No. .___ _�_-5 <br /> (Complete in Duplicate) <br /> Date Issued ___. <br /> Applica+ion is hereby made to the�San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> JOB ADDRESS AND LOCATIO -- ------------------------- ------5------- --- ------------ --------- --------------------------------------- <br /> Owner's Name------------- --- --------- -- ----- - �� Phone---------------------------- , <br /> Address..---------------------------------------------- ......... -•---- ------------ --- -----------------------------------------------------------•------•---•--------_-•----•-•--....... <br /> Contractor's Name---------------------------------------- ------------------------------- ---------- -------------------•----•--- Phone.---------------------------------- <br /> Installation <br /> -•---------------- -•----------Installation will serve: Residence ,Apartment House E] Commercial E] Trailer Court E3Motel E] Other ❑ <br /> I Number of living units:iNumber of bedrooms -,2*.- Number of baths :___-___ Lot size ----------_________ <br /> Water Supply: Public system�Community system ❑ Private ❑ Depth to Water Table .--- -- ft. <br /> Character of soil to a depth of 3 feet: Sand E] Gravel E] Sandy Loam E] Clay Loam ❑ Clay ❑ AdobeHardpan ❑ <br /> Previous Application Made: Yes NoNew Construction: Yes No E] ' <br /> TYPE'OF INSTALLATION AND SPECIFICA IONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well_________________Distance from foundation-------------------Material_-____...__----.._..--_.__________._--_--.-_--. <br /> ❑ No. of compartments---------- -----------Size-----••------------------------Liquid depth----------------- --------Capacity....................... <br /> Disposal Field: Distance from nearest weli-----------------Distance from foundation--------------------Distance to nearest lot line--_--__---------- <br />; ❑ Number of lines-----------------------------------Length of each line--------------------- --------Width of trench.--------------------------.-_-_--- I <br /> Type of filter material-------------------------Depth of filter material-----------------------Total length------------------------------------------ <br /> Seepage Pit: Distance to nearest well -------Distance from foundation-------------------_Distance to nearest lot line_-_____.__-______ <br /> ❑ Number of pits--------------- -----Lining material-----------------------Size: Diametef-----------------------Depth--------------------------------- <br /> Cessp ol.. Distance from' nearest well)"---_ . _ _____ istance fr`o_m foundation__,D___l-__.__.Lining material___. <br /> Size: Diameter. ,J tp-----------=----Dept h--------s47-----------------___----- ------Liquid Capacity----------------------:-_-gals. <br /> Privy: Distance from nearest well-------------------------- ----- --------------Distance from nearest building-,_-_.____-__.____-_--_-•__--_.___---._. l <br /> ❑ Distance to nearest lot line--------------------------------------------------------------------------------------------•-------••---------------------------------------- <br /> } <br /> Remodeling and/or repairing (describe): '------------------•----------------------------......--------......... <br /> i <br /> - ------------------•----------------•----------------------------•-•---------------------------------------------------••------------------------------------------ <br /> I hereby certifythat I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> /E1 � i <br /> Si ned � .! A r �.E'I 7"- - -------------------------------- - Owner and or Contractor <br /> By:---..... J ------------------------------------------------_--•----------------------------(Title)-------------------------------------- ------------------------- <br /> (Plot plan, showing size of W. location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> i <br /> FOR DEPARTMENT USE ONLY. �J <br /> APPLICATION ACCEPTED BY---. ------ - ------------------------------ DATE 'r� ` .' 'c?�` <br /> REVIEWED BY------- A <br /> � � DATE__. __�_--•------------••-•-•----•----------•------- <br /> ----- ----------- --------------------------------------------------------- <br /> ILV <br /> BUILDING PERMIT ISSUED--------- ------------•--- DATE_`�----------------------------------------------------- <br /> --------------------- �.-- - --- <br /> Alterations and/or recommendatio s: -----------------------------------------------------------------------------------------=----------• - <br /> -------------------------------------------------- ------ ----- ------------------------------------------------------------------------------------------------------------------------------------------------ <br /> ------------------------------------- /"-- ------ - ---------- ---- ------ ---------- ------ ............. <br /> --- - ----- ------ -- - <br /> FINAL INSPECTION BY:..__ .._._. _ _ <br /> � �--=�•- -�:;�----- ----•-- ------------- Date-----------------�� ---------------------- ----•-----------------•--• <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> Es---9-2M 145446 ATW00D 12-54 <br />
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