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9366
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4200/4300 - Liquid Waste/Water Well Permits
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9366
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Entry Properties
Last modified
6/11/2020 10:07:12 PM
Creation date
12/4/2017 11:27:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
9366
STREET_NUMBER
2605
Direction
N
STREET_NAME
E
STREET_TYPE
ST
City
STOCKTON
SITE_LOCATION
2605 N E ST
RECEIVED_DATE
12/03/1957
P_LOCATION
RAY FLANNAGAN
Supplemental fields
FilePath
\MIGRATIONS\E\E\2605\9366.PDF
QuestysFileName
9366
QuestysRecordID
1720976
QuestysRecordType
12
Tags
EHD - Public
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0 <br /> � q <br /> n� APPLICATION EO,, SANITATION PER Permit No. <br /> I, <br /> (Complete in Duplicate) <br /> Date Issued ---•______ ______ ___ <br /> ppli ation 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. t <br /> JOB ADDRESS AND OCATIO, ------ _-4---ds----------- :_- _ <br />( Q. 4 GEr°► _ = "'#✓.* - <br /> Owners Name___ <br /> Address------------------------- <br /> --- -'--- <br /> Contractors Name ----' "'------- - = �) r� <br /> -------------- Phone <br />' Installation will serve: Residence ©,"Apartment Houser❑Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑' <br /> A) s <br /> Number of living units: ___ __ Number of bedrooms = Number of baths '__ Lot size ___ A)c �� <br /> - ------------------- ----- <br /> Water Supply: Public,`ystem '[�]�mmunity system ❑ Private ❑ Depth to Water Table . ..... ft.. <br /> I Character of soil,to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam E] Clay ❑ Adobe M"Hardpan ❑ t <br /> P <br /> Previous Application Made: Yes ❑ No -New Construction: Yes 2--1q~o ❑ FHA/VA: Yes ❑ No ©r- <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or•cesspool permitted if public sewer is available within 200 feet.) <br /> ?+ .' Na. of compartments Size Liquid depth - C6pacify I <br /> Septic Tan Distance.from nearest well-----------------Distance from foundation--------------------Material <br /> ` p y <br /> Disposai Fiel Distance from nearest well----------------Distance from foundation---------------------Distance to nearest lot line---.--__-____-__- <br /> Number of lines--------_--•----------------------Length of`each line-------------------------------Width of french----------------------f---------- . <br /> Type of filter material-----------------------_Depth of filter material----------.------------Total length_!----------------------------------------- <br /> Seepage <br /> .--_--_.___:-_----____ I <br /> Seepage Pit: Distance to.nearest well -b-Q_----------Distance rpm <br /> . . --- foundation__CeDistan-e�to <br /> nearest <br /> pa <br /> tret lot lin �� t e __ <br /> Number _ <br /> Number of•pits------�-------------'Lining ____.Sim er- -- n------- Q----•--------; - <br /> Cesspool: Distance from nearest well------- --------Distance from foundation------------------.Lining material______________________________________ <br /> ❑ Size: Diameter--------------------------" -------Depth----------------------------------------------------Liquid Capacity----------------------------gals! <br /> Privy: Distance from nearest well__'" - _-.--__._;__-___----------------- <br /> __Distance from nearest bug <br /> ildin F � <br /> ❑ Distance to-nearest lot line!,-----'-::---=---- ----- -------------------------------------•------------------•--=--------- ------ ----------- '---------=---------- <br /> Re cleling Wd/or repairing (describe):--- -----(`='�°-6"J, _"775s7__ -.."C, 1 --------- � <br /> ---------- , --------------------•.--------•----..--------_---.-----_--- ----.•-_----_-----_---- -----------------------------.---------___- ------------_------------------� <br /> _ __ ___________ --- •_---_ <br /> Y P P -------."=--�p---------------------------------=-- ------------------------- <br /> . -------- herebycertify that I have re ared this application and that the work will� --�--------------------------------------- ---------------------- ------- <br /> I ------ <br /> be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and re'ulations of the San Joaquin Local'Health District. <br /> i (Signed) r-----`-z_------ = �''� � y` ------------------------------------- --------------------------------------------------y{yry7�---------- <br /> LOwner and/or Contractor) <br /> By:------•----------- .. 1 ��. ---------------------------------------------------------(Title) "'' �Y4 <br /> (Piot plan, showing size of lot, IL ation of system in relation to wells, buildings,etc., can be placed on reverse side). <br /> I <br /> { ` FOR DEPARTMENT USE ONLY " <br /> �f`APPLICATION ACCEPTED BY---------------------------- ----- ------------------ -----------• DATE-------"------------ <br /> -------- <br /> REVIEWED BY - DATE_._, =_ ' .� =-----•-------- <br /> BUILDING PERMIT ISSUED------------------------ ---------------------- DATE.----- --- <br /> Alterations and/or recommendations:--------------------- ----------------------- ----------------------------------- ----- • :; <br /> Y T - <br /> f ----- -- <br /> .7-----------� lam- ----- fi r----- -, �-------------- <br /> .� � --•5.2------- �� c _'-T_c. .. - .P % :------ c! °7�? -• • ----- <br /> ------------------------ <br /> FINAL INSPECTION•BY:----- - "-- - _ _ - - Date------------------- -� <br /> - <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-4-2M Revisea 1-57 F.RCO. <br />
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