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74-687
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CORA POST
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4200/4300 - Liquid Waste/Water Well Permits
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74-687
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Entry Properties
Last modified
4/18/2019 10:06:38 PM
Creation date
12/4/2017 8:07:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
74-687
STREET_NUMBER
5798
STREET_NAME
CORA POST
STREET_TYPE
RD
City
LODI
SITE_LOCATION
5798 CORA POST RD
RECEIVED_DATE
07/31/1974
P_LOCATION
VISTA CONST.
Supplemental fields
FilePath
\MIGRATIONS\C\CORA POST\5798\74-687.PDF
QuestysFileName
74-687
QuestysRecordID
1702012
QuestysRecordType
12
Tags
EHD - Public
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FQR OFFICE USE. <br /> APPLICATION FOR SANITATION PERMIT <br /> -...... Permit No. ..� 6 k7 <br /> SComplete in Triplicate! <br /> ............. <br /> ........................................ p-c - 7y <br /> ........ This Permit Expires it Year From Date Issued Date Issued .................... <br /> Application is hereby made to the San Joaquin Local 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 and existing Rules and Regulations: <br /> JOB ADDRESS/LOCATION ,......7 7._q�___,_Caea Pb K.D...... . .... ....::... CENSUS TRACT <br /> .......................... <br /> Owner's Name V.t5'r�, .----CoNs~ CQ.�......................... ...............Phone ...q78' 7�PA <br /> Address - - .._. '�rJ�lcr?�_...-lam.._....••---..._..-••-•----•............'City ..arm- .i`Q.r•�................. <br /> Contractor's NameAl°12tSgi....:�.-SQA--s----.......r.- ................License # o ff`. Y3..... Phone Y!A6 g n. <br /> Installation will serve: Residence {Apartment House 0 Commercial oTraller Court 0 <br /> Motel ❑Other ...---------•.................•-------••--•- <br /> Number of living units:-...-f Number of bedrooms .3......Garbage Grinder ............ Lot Size .............. <br /> Water Supply: Public System and name --.......................................... ----------------------------.....................................Private <br /> Character of soil to a depth-of 3-feet: SandEl -Silt-[-] .Cloy�O Peat❑ Sandy=Loam=o�C-lay-L- ami--- ^� <br /> Hardpan It@ Adobe Fill Material ............ If yes, type --------------------------- <br /> { <br /> (Plot pian, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side.) <br /> NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) ; <br /> PACKAGE: TREATMENT [ ] SEPTIC TANK{ ] Size....----!2©d GA <br /> -------- <br /> Liquid Depth ..5�'` .y?-.......... E <br /> - <br /> Capacity . Z S?.GAL Type-Pt2K..:CA5X-Material.C?4NcKcrc_ No, Compartments _.... ............ <br /> ..j <br /> Distance to nearest: Well .......... ........................Foundation __--���.._.......__ Prop. Line _. .............. <br /> LEACHING LINE [ ] No, of Lines ....--_�-------------- Length of each line------q0!.............. Total Length ....�7P i_............. <br /> 'D' Box....:..------ Type Filter Material ..... Depth Filter Material .......1_VI........... . .. <br /> i <br /> Distance to nearest: Well ........................ Foundation ........ ; ........... Property Line .-3 4...._.......__� + <br /> 10 <br /> SEEPAGE PIT [ { Depth ..- •- Diameter .3 ......... Number ------ ------------------ Rock Filled Yes No <br /> Water Table Depth .......`(!�............ <br /> -----------------------Rock Size -.Y2!---)...-----..-.. <br /> Distance to nearest: Well ..---------------•.............-----....Foundation ............ Prop. Line -%Z. ........... I <br /> REPAIR/ADDITION(Prev. Sanitation Permit# ............................................ Date ..................................I <br /> Septic Tank (Specify Requirements) ............... --------------••---......--------------------..............._..--••----------------- <br /> Disposal Field (Specify Requirements) ..... ------------- ---------- ............•........... f <br /> .............................................................. <br /> (Draw existing and required addition on reverse side) <br /> I hereby certify that I have 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 San Joaquin Local Health District. Home owner or liten- 4 <br /> sed agents signature certifies the following: <br /> "I certify that in the performance of the work far which this permit Is issued, I shall not employ any person In such manner <br /> as to become subject to Workman's Compensation laws of California." ' <br /> Sig ------------------••--•----------•------------ ...- .-..... Owner <br /> E <br /> BY .... - -(5)"- - ..:- ........................................... .Title ...ES.P`......... <br /> If other than owner) <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY ................ .:. ..:................... ---......-----------............_....... DATE .......... f.. .. <br /> BUILDING PERMIT ISSUED .......... ...... . ........•- p - <br /> ••- .- � / <br /> AT ................... <br /> ADDITIONAL COMMENTS .... <br /> ............................. .... .... ..---•-................................. <br /> .............-.----•------------------------------------- ---.....---•--••----•.......---- .......... ._..__. ..._..__. <br /> ...............................I.._...............: <br /> Final Inspection by: <br /> .•--•--•• ...... ..............................I •••••-•••-•-••..••--••..................-----..Date .......-7.. f <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> CIO <br /> E. H.I.3 24 W68 Rev. 3M 7I77 'A <br />
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