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74-718
EnvironmentalHealth
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EUCLID
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2327
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4200/4300 - Liquid Waste/Water Well Permits
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74-718
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Entry Properties
Last modified
4/18/2019 10:08:11 PM
Creation date
12/5/2017 1:42:33 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
74-718
STREET_NUMBER
2327
Direction
E
STREET_NAME
EUCLID
STREET_TYPE
ST
City
STOCKTON
SITE_LOCATION
2327 E EUCLID ST
RECEIVED_DATE
8/20/1974
P_LOCATION
RICHARD GROSS
Supplemental fields
FilePath
\MIGRATIONS\E\EUCLID\2327\74-718.PDF
QuestysFileName
74-718
QuestysRecordID
1733827
QuestysRecordType
12
Tags
EHD - Public
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FOR OFFICE USE: <br /> APPLICATION FOR SANITATION PERMIT <br />_....._..... Permit No. ..7_�,_.... <br /> (Complete in Triplicate) <br /> . <br />......................................................... This Permit Expires 1 Year From bate Issued <br /> �... <br /> 74 <br /> Date Issued ..9� ... <br /> Application is hereby made to the Son 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 /> J08 ADDRESS/LOCATION ......Cs ., rl..__..... .:..�/!!4............ ................................CENSUS TRACT .......................... <br /> Owner's Name .__.. ?trf .. Phone <br /> � .�...... �.. <br /> ... ...Address <br /> Contractor's Name - ...... 41ces-4"icense #� ., .. Phone <br /> Installation will.serve: Residence /Apartment House❑ Commercial ❑Troller Court 0 <br /> Motel ❑Other ------_---- .............................. <br /> Number of living units:__._ Number of bedrooms . g Lot Size . <br /> . _ .e/.j_w.......... <br /> - .._.. �_---Garbo e Grinder .__. <br /> Water Supply: Public System and name .._-• -- .....- ...................................................Private ❑ <br /> Character of soil to a depth of 3 feet: Sand❑ Silt❑ Clay 0 Peat❑ Sandy Loam ❑ Clay Loam <br /> Hardpan ❑ Adobe ' Fill Material ............ If yes,type ____________________________ <br /> (Plot plan, 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{ 1.5 ............................................... Liquid Depth .......................... <br /> Capacity .---•---•----------- Type .................... Material---_-------------- No. Compartments ...................... <br /> Distance to nearest: Well ....................................Foundation ...................... Prop. Line <br /> LEACHING LINE fV No. of Lines ._ Length of a ch II a..__.... D_f_... Total Length ...a1............... <br /> Z <br /> 'D' Box - - Type Filter Material .. ...Depth Filter Material -._, �.`..`�...................... <br /> Distance to nearest: Well �' ... .. f <br /> .r/h- ..a. .. Foundation .--_��'._--•----...--.-- Property Line .�..................'� <br /> SEEPAGE PIT (,V/ Depth -r c jb <br /> ' ...---- Diameter :�!..t---•--.. Number ...-• -•-----_--.••- --..... Rock Filled Yes No <br /> Water Table Depth .. ._ _ <br /> Rock 9" <br /> Distance to nearest: Well _,Y :. J____. __.._ _...Foundation ... ........ Prop. Line ... ............... <br /> REPAIR/ADDITION(Prev. Sanitation Permit# ........---___---_---.-__----•.......... Date ..................................] <br /> F <br /> Septic Tank (Specify Requirements) .................. -.._. ._.. e.*.� <br /> . <br /> Disposal Field (Specify Requirements) / �------........................................ - -- -------------•-••- ------- ......... -••------....._ <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 licen- <br /> sed agents signature certifies the following: <br /> "I certify that in the performance of the work for 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 /> Signed ....._.... Owner <br /> --`�- <br /> BY �'' -�! �, 4:�i. .-.... `ry ------------- - Title .....�.��. `� .. <br /> (If other than owner) I <br /> FO DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY .._. .. _. _.. : .. _ .....----•--•-•--•......... ........•. .......... ......... DATEZ �_/_ Y................. <br /> BUILDINGPERMIT ISSUED .....................................................•..............,......................................DATE _-------_...............-. ---------- <br /> ADDITIONALCOMMENTS ............_.................•--...........-----.....----------...----•----------------•- ....... <br /> ..... f ...:..... .................................••-•-------•--•-............-•------............---------•-------.....----.......----•••---•-.. <br /> ................... <br /> Final Inspection b . ........................................-------------._ ..._ _.._....---.Date _ <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> E. H.1.3 24 1-'68 Rev. 5M 7/723 ,1 <br />
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