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7640
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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CHEROKEE
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1980
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4200/4300 - Liquid Waste/Water Well Permits
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7640
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Entry Properties
Last modified
5/6/2019 10:07:16 PM
Creation date
12/4/2017 5:24:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
7640
STREET_NUMBER
1980
STREET_NAME
CHEROKEE
SITE_LOCATION
1980 CHEROKEE
RECEIVED_DATE
06/04/1956
P_LOCATION
TONY GIGLIO
Supplemental fields
FilePath
\MIGRATIONS\C\CHEROKEE\1980\7640.PDF
QuestysFileName
7640
QuestysRecordID
1686427
QuestysRecordType
12
Tags
EHD - Public
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APPLICATION FOR SANITATION PERMIT Permit No. ...._x __7--6.. <br /> (Complete in Duplicate) 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 LOCATION----------8 <br /> Owner's Name..-------.-j�--_alv_ Phone <br /> ------------ <br /> 1 ---------------- ----- - ------------------: <br /> Address. { , rs' 1`�7 Q-----------------------...-•----•---------•------------- --------------•• -------------------------------------• -------- <br /> Contractor's Name------ 0.-�L _ ---•-- —------- -- Phone - r <br /> Installation will serve: Residence [s Kpartment House ❑ Commercial ElTrailer- Court ❑ Motel ❑ Other ❑ <br /> a Number of living units: {------ Number of bedrooms ___". umber of baths .1---- Lot size --------- . <br /> Water Supply: Public system Dq--Community system ❑ Private ❑ Depth to Water Table 41-"_ ft. C <br /> Character of soil to a depth of. 3 feet: Sand.❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe 5�_ Hardpan ❑ <br /> Previous Application Made: Yes ❑ No g_New Construction: Yes Dk_No ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if.public sewer is available within 200 feet.) <br /> Septic Tank: va,nce from nearest well--..-____---.___Distance from foundation_----------------Materia------------------------------------------------- <br /> ❑ f compartments- - ---------------------Size---------------- Liquid depth---------------- -------.Capacity-:--------------------- <br /> Disposa4���ber <br /> ldDitance from nearest well-----------------Distance from foundation--------------------Distance to nearest lot line.--_--.----.____- <br /> ❑ of lines---------------------- Length of each line--------------- --------------Width of french--------------------=--•----------- <br /> s ype of filter material-------------------------Depth of filter material-----------------------Total length------------------------------------------ <br /> o <br /> r d <br /> t am__-_�_-----Dista iye to nearest lt line---- ---.f---- <br /> Seepage Pit:, Distance to nearest well �"P'+RL7'stance from foundation__.c <br /> ' 3$------ ---Depth.-.-- <br /> ---------------- <br /> Number of pits------�__.---..___--Lining material-�..�- -------- : Diameter--- <br /> Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material------------------------------------- <br /> 0 Size: Diameter---------- ------ --------- - -----Depth-----------•----------- -----------Liquid Capacity_--------------------------gals. <br /> Privy: Distance from nearest well ----------------- ------------ -. --Distance from nearest building------------------------------------------ <br /> ------------- <br /> ❑ Distance to nearest lof line-.----- ----------- ------- <br /> ,. <br /> Remodeling and/or repairing (describe):----------------------- - ----..-----------------------------•---_..---------•-------------------- •--------- <br /> --------------------------- <br /> --------------- <br /> ------•-----...---•-- <br /> --------------------------------------------------•---• ------•----------•--•-------------•------•------------------------------•-------------------------------------------...-----....------------------------------------- :r <br /> I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules an regulations of the San Joaquin Local Health District. <br /> (Signed) " - (Owner and/or <br /> 5� <br /> ------------------------(Title)--.-. =`--------------------------------------- <br /> (Plot pian, showing size of lot, location of system in relation to wells, buildings, etc., can be placed an reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY------- ------------ ='. =----------- DATE- <br /> REVIEWED BY------------------------------------------------ ��- ---------------------------------------- <br /> BATE <br /> BUILDING PERMIT ISSUED--------------------------- DATE <br /> - ---- ------------------------------------------------------- <br /> Alterations and/or recommendations:---------------- ----•---------- -------------------------------•------------------------------- ... <br /> ---------------------------- -------------•- -------------- --- -----�------------------------- ---------------- .-------- -- ----------------------------------...- <br /> --------=- ------------------- - <br /> - --------- <br /> y . - --------- ---------------------- ----------------------------------------------------- <br /> u ---- ------------------ -----------------•---------------------- ---------------------- <br /> Y � <br /> --------------- ---------------- -------- ----------- ------------------------------------- --------- -------- <br /> FINAL INSPECTION BY--------- ------- ----- <br /> - Date--- = CR- - �~ ------ ------------------ <br /> FINAL <br /> 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 /> n E5---9-2M 145446 ATwonD 12-54 - <br />
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