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5684
EnvironmentalHealth
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EL DORADO
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4200/4300 - Liquid Waste/Water Well Permits
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5684
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Entry Properties
Last modified
1/31/2019 8:52:02 AM
Creation date
12/5/2017 12:25:29 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
5684
STREET_NUMBER
0
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
FRENCH CAMP
SITE_LOCATION
OLD HWY 50/EL DORADO ST
RECEIVED_DATE
10/22/1954
P_LOCATION
CRAFT CONST CO
Supplemental fields
FilePath
\MIGRATIONS\E\EL DORADO\0\5684.PDF
QuestysFileName
5684
QuestysRecordID
1727457
QuestysRecordType
12
Tags
EHD - Public
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O�A� APPLICATION FOR SANITATION PERMIT Permit No. ------- <br /> (Complete in Duplicate) <br /> Date Issued 5/1-- <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 /> ,e r-t P 0 d-vf-0 0 S'7-" , ----- 1, 0�_,_.s. .......... ---- <br /> --- --------__----------------------------- <br /> JOB ADDRESS AND LOCATI N <br /> Owner's Name------- <br /> - - ---------- - ------------------------------------------------------------------------------- Phone-----•----------------------------- <br /> -------------------------------- <br /> ----------------------------------------------........ <br /> Address-------- ------- -- -------- ----- — <br /> --11!rgr <br /> 4� __a� *d- <br /> Contractor's Name_.----4Z-------0- -- ------- ------- -- ---------------------- Phone ......6!�j2kAt_ <br /> Installation will serve; Residence [] Apartment House [I Commercial96--Tf61ier Court 0 Motel 1-1 Other [I <br /> Number of living units: -------- Number of bedrooms -------- Number of baths /--- Lot size _________________________________ <br /> Water Supply: Public system ❑� Community system El Private J��epfh to Water TableA0- ft. <br /> Character of soil to a depth of 3 fee+: Sand tr-1�ravel El Sandy Loam Ej Clay Loam [3 Clay El Adobe El Hardpan El <br /> Previous Application Made: Yes [:1 No Z�/New Construction. Yes 0, No El <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> ----J3_7_`___.MateriaI----- <br /> ----- ----- <br /> Septic Tank: Distance from nearest well---- Distance from foundation - ----------------- ------- <br /> compartments--------44------------- Liquid depth......el-., " _904j---------- <br /> No. of T- --------Capacity-- <br /> Disposal Field: Distance from nearest well_.___,j7_a----Distance from foundation---J-(j........Distance to nearest lot I*ine_jjr4 ........ <br /> Number of lines--------------1---,7-;------------Length of each line________gpe9_:�---------Width of trench__20__'_f-------------------- <br /> Type of filter material-_-_/X__W_�/__Depth of filter material_.____-/9-"`----Total length ---------------------------- <br /> Seepage Pit: Distance to nearest well----------------------Distance from 'foundation------_------------Distance to nearest lot line_______.--_______ <br /> E] Number of pits_------------------Linin material-----------------------Size:-----------------------Size: Diameter-----------------------Depth._----------------------------- <br /> Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material__-.___--------------------------------- <br /> ❑ Size: Diameter-------------------------------- -------Depf h---------------------------------------------------Liquid Capacity-_------------- gals. C)� <br /> Privy: Distance from nearest well------------------------------------------------Distance from nearest building_____..._______________________._____..._. - <br /> 11 Distance to nearest lot line---------------------------------------------------------------------------------------------------------------------------------------------- <br /> Remodelingand/or repairing Idescribe)---------- -------------------------------------------------------------- ----------------------------------------1-1----------------------------- <br /> --------------------I-------------------------------------------------------------------------------------------------------------------------------11-------------------------------------------------------------------- <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, SjAte laws, and ules and regulations of the San Joaquin Local Health District. <br /> 7 , u" .1 <br /> (Signed)---- ---------------------- L�Qwaea -Contractor) <br /> Zt------- --- -- -- ------7- ------ 042L <br /> By:------- ffifle)__�e 4:7� <br /> (Plot plan, showing elation to wells, buildings,-etc.,-_c_;_n be placed an reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY--- ------------------------- __1--------------------------------------------------- DATE------------- Y <br /> ------------- <br /> REVIEWEDBY--------------------------------------------- ------------ --- -------------------------------------------------------------- DATE---------------------- ------------- <br /> BUILDINGPERMIT ISSUED----------------------------------- --- --------------- --------------------------------------------- DATE------------------------------------------------------------- <br /> Alterationsand/or recommendaf ions:------------------------------------- ------- --------------------------- ----------------------------------------------------------------------------------- <br /> ------------------------------------------------------------------------ ----------------------------------- ----------------------------------------------------------------------------------------------------------------- <br /> -----------------------------------------------------------------------------------------------------------------------I--------------------------------------------------------I-- ------ ------11---I., <br /> -------------------- ----------------------------------------------------------------------------------------------------------------------- ..-..------------------------------------•----- ----------------------------- <br /> ---------------- <br /> ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> FINAL- INSPECTION ---------------------------------------------- Date------ / _' 7- -------------------- <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 Marif"a, California Tracy, California <br /> ES-9-2M Revised W-2100 <br />
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