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11511
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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D
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DRAKE
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1985
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4200/4300 - Liquid Waste/Water Well Permits
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11511
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Entry Properties
Last modified
10/24/2018 8:52:14 AM
Creation date
12/4/2017 10:28:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
11511
STREET_NUMBER
1985
Direction
S
STREET_NAME
DRAKE
SITE_LOCATION
1985 S DRAKE
RECEIVED_DATE
12/4/1959
P_LOCATION
W M FOWLER
Supplemental fields
FilePath
\MIGRATIONS\D\DRAKE\1985\11511.PDF
QuestysFileName
11511
QuestysRecordID
1717227
QuestysRecordType
12
Tags
EHD - Public
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APPLICATION `FOR SANITATION, PERMIT Perr*sW4c,,Z_5__........... <br /> This Permit Expires <br /> 1 YeeDuplicate) <br /> 'P <br /> Date Issued <br /> From Date Issued <br /> Application 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 /> 0 JOB ADDRESS AND L CATION. , < A.,e --------------------------------------------------------------------------•------------ <br /> Owner's Name.-------- --/X- t------ .r J .1_.. ' Phone <br /> ••------------------ --------------------------- <br /> Address------------- - -- <br /> Contractor's Name -------- --------------------------------------------------------------_ Phone----------------------------------- <br /> - <br /> Installation will serve: Residence Apartment House ❑ Commer'cialL�❑ Trailer Court E] Motel ❑ Other ❑ <br /> Number of livingunits: _ <br /> ___ Number of bedrooms'__,;2--_ Number of bath;__ __ Lot size �-_,� _ _.r------------------------------_-._-_._ <br /> Water Supply: Public system [Community system 0 Private/El Depth-4o Water Table __�-, It. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sai1�y Loam-7[_1\ Clay Loam ❑ Clay ❑ Adobe Hardpan ❑ <br /> Previous Application Made: Yes ❑ No g3l"'New Construction:,Y,es's',❑ No.'®— FHA/VA: Yes ❑ No E?.— <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> s <br /> S pti4 Tank: Distance from nearest well------------------ from foundation--------------------Material _-._----------.-_.---.--_---_--_--. _1------- <br /> 1 /,4 s No. of compartments-------------------------?Sizer -!-------------------------Liquid depth---------- ------ --------Capacity----------------------- <br /> Disposal Field: Distance from nearest well................;Distance from foundation--------------------Distance to nearest lot line----------------- <br /> AXNumber of lines-----------------------------------Length of each line------------------------------Width of trench-------------------------------- <br /> Type of filter material_________________________lDepth of filter mate-ial_---------------------_Total length_---------------_:_-------__---_---------- <br /> Seepage Pit: Distance to nearest well _.-:=�._---_--Distance rn-- nd ' ion___-4P.P...._._.Distance to nearest�t line---/ ------ <br /> .;yOd <br /> ®�! Number of pits--------Z----------Lining mater' s .Size: Diameter---% _.__._Depth___._.07'0_---______._--_ f_ <br /> Cesspool: Distance from nearest well-----------------D• tancesfro' .oundatio'n____---___---_-._.Lining material_______-_--__.-_._.________---__-_-. <br /> Size: Diameter-------------------------------------De ` ------------------------------------Liquid Capacity gals. <br /> Privy: Distance from nearest well---------------------------------__.__.________-Distance from nearest building---------------------------------- -.--. _ <br /> ❑ Distance to nearest lot line--------------------------------! -------------------------------------------------------------------------------------------- <br /> �� I-' -- - — <br /> Remodeling and/or repairing (describe)=- ---- ------------f.-¢= -'r�- �•- ---� ----------F---•---------------------------------------•---------------- <br /> } <br /> ---------------------- -------------------------------------------------------------------•-------------•----- -------------------------------------------'------------------------------------------ <br /> , <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 and regulations of the San Joaquin Local Health District. ` <br /> (Si ned `_ ® ` <br /> 5 )----•- ----------- -• ---- ---�--- -- �•-���-� -- --------------------------------------------�--------------[Q6w%ecznad/or Contractor) <br /> By:---------------- --•--------------- �sysfem <br /> � --------€--------------------------------------(Ti+le) �/Z�' .......... ----------------- <br /> (Plot plan, showing size of lot, loc n relafion to wells, buildings, etc., can be placed on reverse side). <br /> t <br /> FOR DEPARTMENT`USE`ONLY' ` --� r <br /> APPLICATION ACCEPTED BY------ e{ a 5 --`---------------------------------------------------------------- DATE---- 1-12---- <br /> ---------------- <br /> REVIEWED BY--------------------------------------------- -------------------------------------------------------------------------------- DATE-------------------------- ------------ <br /> ---------------------------------- <br /> BUILDINGPERMIT ISSUED----------------------------------------------------------------------------------------------------- DATE--------------------------------------------- ----------- <br /> Alterationsand/or recommendations:-------------------------------------------------------------------------•----------------------------------------------------•-------------------------- <br /> -------------------------------•--------------------•--------------------------------------------------------------•----------------------------------•--------------------------------- ----------------•------------------- <br /> ---------------------------------------------------•- ----- - - -------------- D- - ---------------------------•-----• ----•- - ----•-------------- - -------------- ------------------ - --- <br /> --- ---- --- ---- ---- ----- ------- ------- ---- - ----- -- ------------ ---f -- ------ --------------- ------------------------------------------------------------------ <br /> f <br /> 102 <br /> FINAL INSPECTION Y:- Date <br /> f <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street,' ,132 Sycamore Sties+ 814 North "C" Streat <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> F <br /> ES-9-2M Revised 8-'59 F.P.Co. <br /> r <br />
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