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17245
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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17245
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Entry Properties
Last modified
12/15/2018 10:22:09 PM
Creation date
12/4/2017 5:42:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
17245
STREET_NUMBER
5700
Direction
E
STREET_NAME
CHEROKEE
City
STOCKTON
SITE_LOCATION
5700 E CHEROKEE
RECEIVED_DATE
4/9/1964
P_LOCATION
ALBERT F STEIN
Supplemental fields
FilePath
\MIGRATIONS\C\CHEROKEE\5700\17245.PDF
QuestysFileName
17245
QuestysRecordID
1685581
QuestysRecordType
12
Tags
EHD - Public
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FOR OFFICE USE: <br /> ----------- ------ ------ <br /> --------- ------------------------ ------------------- APPLICATION -FOR SANITATION PERMIT Permit No. z)---! <br /> .4 72 <br /> ------------ --------------- -------------------- ----- -I., (Complete in Duplicate) <br /> -------------I----------------------- .-I........ --- Date Issued _,_O(/? 41- <br /> ... ..5 <br /> This Permit Expires 1 Year From Date Issued <br /> Application ishereby:-made to the Son Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This applicafloh'is-made in_compliance with County Ordinance No. 549. <br /> JOB ADDRESS AND LOC <br /> , ------ ------ ( <br /> Address-------- o Ph <br /> -- ---------- <br /> Owner's Name__.---------- +__ , ' - <br /> I <br /> ��: - one--------- <br /> 'r- -------- ---------- <br /> .............. <br /> Contractor's Name-_ _ _ 1.1'aw-r-is- -----V--a-u- -Phone---------- - <br /> - --------------- <br /> Installation will serve: .Residence E� Apartment House, <br /> 4, ❑ Commercial B'51"Trailer-Court ❑ atel E] Other/E]- ,- <br /> t I LIJ <br /> Number of living units- ------i- Number of bedrooms777 Number of baths Lot'size ---4, <br /> f A - I, P�P.- <br /> Water Supply: Public-system [I. Community system El/Private &�O<epthto Water Table,.330,47 <br /> Character of soil to a depth of 3 <br /> feet: . Sand El Gravel'-E] Sandy Loam E] Clay.Loam E] C16y ❑ Adobe eHardpan ❑ <br /> Previous Application I No <br /> Made: (If.,�Ies,cicite_ ------- No ❑ New Construction: Yes No!E] <br /> I i $ * FHA/VA: Yes E <br /> TYPE OF INSTALLATION AND SPECIFICATIC"NS:/ <br /> (No septic tankor cesspool lo <br /> ermiff4d if publiye�wer is available within 20,0Je6t.) r <br /> Septi -rank: Distance from nearest Y� I_A§P----- Dista frorp fpundation__-/-�_.P ___=.___.Mater{__ <br /> ------------------ <br /> rtmenfs----IV( i IA4� <br /> Y. t <br /> No. of pa f�'7-Licl,h%�,th ---------:-Capacity-., <br /> i( 'mfoundation_ <br /> I '-f. -I-------- <br /> Disposal Field: Distanc compartments_.__ <br /> e fr nearest ell..-,------_Distance from founclati <br /> on-.YAP----- Distance to nearest I lin <br /> I Number,of lines--- Length of each line-" ---------e�Viclfh of fre�*_ul ---- <br /> I dpl( ----------- <br /> I-----Distance from foundation-_./P!----LDistance to nearest lot iine__.__, <br /> Distance to nearest well--- <br /> 0 <br /> T 'ial4 Depth of.filter matena1__1.,/_(7_ 11 iTof,l length.... .... <br /> y filter mater <br /> Seepage Pit"; <br /> 'n- Number of pits.-_- ----Lining �_ <Sizel: Diameter/-------3:5�� Depths :;2- 5-1 <br /> Cesspool: I I I . __1-------------------- ------- <br /> Distance frorn..near;st,`w6I1------------- Distance from found-dlibh"-------------/!!.- Lin in g. ,material.... <br /> / <br /> Size. Diameter- <br /> El - -- --- ------!---Depth--- i <br /> -------------- ---- -- ...... �,jd Capac fyf_.__V `-----------gals. <br /> Privy: Distance from,rearest well,�' <br /> 1------------------------ --------------------Di'stnce from` nearest building-_.-.__-_-.__--_-__________ _ ---t r <br /> - <br /> 0 Distance to nearest' of line---------- <br /> ------------I--------------------------P- % ----------------------------------- ----------------------------------- <br /> - ---------------- <br /> Remodeling and/or repalring [clescril3iq): <br /> -------- AA,�--------- - <br /> -------------------------- i.------------ -----------------------I------------------------------------------- ----------- <br /> -----------------------I---------- <br /> A---k_'A <br /> ------------------------------------ ----------------------------- -S---------------------------/ I <br /> 1 11. -A /--------------------------------------------------------------------------------- - <br /> ------------------- <br /> ----------------------------------------------------- ----------------------------=��------------------------------I--------I------------------------------------------------------\. <br /> ------ <br /> I hereby certify that I"hav; prepared this application and that+he work will be done in accordance with San Joaquin'County <br /> ordinances, State laws, and rules'a regu Ion <br /> Idt' .5 of the San Joaqoj-n <br /> hqcal Health District. <br /> (Signed)•---=----=- - --------- <br /> -------- -- <br /> Z - -- ---- ----- --- ------------- --------------------------(Owner and/or ConfraA <br /> By:------- --------------------------------------x -------------------------------------(Title)------ ----------------- <br /> --------------------- --- -------- ------- --------- <br /> (Plot plan, show i n;-size-of,lot, location of system in relation to wells, buildings, efIdl.,, <br /> can be placed on reverse side). <br /> % <br /> f. <br /> FOR-DEPARTMI <br /> _E.NTSE ON <br /> APPLICATION ACCEPTED BY------- <br /> -------------------- ------ DATE---------- —-- ---- ------------------- <br /> REVIEWED BY------------- ------- ----------- ---------------- DATE------ <br /> T <br /> - - ---------- -----------------------------------/---------------------- DATE------- <br /> BUILDINGPER-MIT ISS'U'ED-----------`------------------------- --------------------- -------------------------------- DATE-------------------------------- <br /> Alterations <br /> ATE--------------------------------Alterations ando'r-re'commendafions----- ----------- <br /> _7 --------- <br /> ------------ .j--------- --------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------- <br /> ----------I-------- --------------j----1------- -------------------- I-L I <br /> ------------------------------- ------------------------------------------------------ -------------I---------------------------- -------------------------- <br /> --------------------- ----------------------------- ---------------------------- ----- ....... <br /> ----------- -----------I------------------------------------------------------------------------ <br /> jj, -------- <br /> - <br /> FINAL INSPECTION BY ....... <br /> ------ -- - ----------------------------- <br /> SAN JOAQUIN,,LOCAL HEALTH,DISTRICT <br /> 1601 E.Hazellon Ave. 300 West Oak street j <br /> AA <br /> ' 124 Sycamore Street 205 West 9th Street <br /> Stockton,California Lodi,California Manteca,California. Tracy, California <br /> ES 9 REVISED a-S9 3M 3-'63 F.P.00. <br />
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