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88-698
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4200/4300 - Liquid Waste/Water Well Permits
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88-698
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Last modified
12/16/2019 10:07:08 PM
Creation date
12/5/2017 3:31:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
88-698
STREET_NUMBER
6302
Direction
E
STREET_NAME
FOPPIANO
STREET_TYPE
RD
City
STOCKTON
SITE_LOCATION
6302 E FOPPIANO RD
RECEIVED_DATE
03/25/1988
P_LOCATION
JOE SOLARI
Supplemental fields
FilePath
\MIGRATIONS\F\FOPPIANO\6302\88-698.PDF
QuestysFileName
88-698
QuestysRecordID
1769499
QuestysRecordType
12
Tags
EHD - Public
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APPLICATION FOR PERMIT <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE., STOCKTON, CA <br /> Telephone (209) 466-6781 <br /> PERMIT EXPIRES i YEAR FROM DATE ISSUED <br /> (Complete in Triplicate) <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and/or install the work herein described. This application is <br /> made in compliance with San Joaquin County Ordinance No.549 for sewage or No. 1862 for well/pump and the Rules and Regulations of the San Joaquin <br /> Local Health District. <br /> Job Address 6302 East Foppiano Rd City Stkn Lot size 30 acres, <br /> Owner's Name Joe Solari Address 6302 East FO iano Phone 931 1765 <br /> Contractor's Name Clark Well License No. Phone 462 7676 <br /> TYPE OF WELL/PUMP: NEW WELL EX WELL REPLACEMENT ❑ DESTRUCTION ❑ <br /> PUMP INSTALLATION IX SYSTEM REPAIR ❑ OTHER ❑ <br /> DISTANCE TO NEAREST: SEPTIC TANK SEWER LINES DISPOSAL FLD. PROP. LINE <br /> FOUNDATION AGRICULTURE WELL —6-01-- OTHER WELL PITS/SUMPS . <br /> INTENDED USE TYPE OF WELL PROBLEM AREA CONSTRUCTION SPECIFICATIONS <br /> ❑ Industrial ❑ Open Bottom ❑ Manteca Dia. of Well Excavation Dia. of Well Casing 6 5/8.1 1 <br /> Jl Domestic/Private L:kGravel Pack ❑ Tracy Type of Casing Steel Specifications #12 <br /> ❑ Public ❑ Other ❑ Delta Depth of Grout Seal 50 Type of Grout 9 sack ce <br /> ❑ Irrigation --Approx. Depth ❑ Eastern Surface Seal Installed by Clark 0 ,. <br /> Repair Work Done 'J?( Type of Pump s iib H.P. 3 State Work Done fist" 1 i . <br /> Well Destruction ❑ Well Diameter Sealing Material (top 501 j <br /> Depth Filler Material (Below 501 <br /> TYPE OF SEPTIC WORK: NEW INSTALLATION ❑ REPAIR/ADDITION ❑ DESTRUCTION ❑ (No septic system permitted if public sewer is <br /> available within 200 feet.) <br /> Installation will serve: Residence_ Commercial_ Other <br /> Number of living units: Number of bedrooms { { <br /> Character of soil to a depth of 3 feet: Water table depth <br /> SEPTIC TANK ❑ Type/Mfg Capacity No. Compartments <br /> PKG. TREATMENT PLT. ❑ Method of Disposal l <br /> Distance to nearest: Well Foundation Property Line <br /> LEACHING LINE ❑ No. & Length of lines Total length/size 1 <br /> FILTER BED ❑ Distance to nearest: Well Foundation Property Line <br /> u <br /> SEEPAGE PITS ❑ Depth Size Number t ' <br /> SUMPS ❑ Distance to nearest: Well Foundation Property Line <br /> DISPOSAL PONDS ❑ <br /> I <br /> I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin county ordinances, state laws, and <br /> rules and regulations of the San Joaquin Local Health District. <br /> Home owner or licensed agent's signature certifies the following: "I certify that in the performance of the work for which this permit is issued, I shall not <br /> employ any person in such manner as to become subject to workman's compensation laws of California." Contractor's hiring or sub-contracting signature ° <br /> certifies the following:"I certify t in the pe ance of the work for which this permit is issued,I shall employ persons subject to workman's compensa- <br /> tion laws of Californ' .' <br /> The applica ca f r I ' i i cti o dr ing on reverse side. <br /> Signed Title: VP Clark Well Date: 3-25-88 <br /> L___ FOR DEPARTMENT USE ONLYApplication Accepted byDate 3 1Jt1 Area <br /> Pit or Grout Inspection by Date Final Inspection by Date <br /> Additional Comments: .S <br /> ❑ Stk 466-6781 ❑ Lodi 369-3621 ❑ Manteca 823-7104 ❑ Tracy 835-6385 <br /> Applicant- Return all copies to: Environmental Health Permit/Services 1601 E. Hazelton Ave., P.O. Box 2009, Stk., CA 95201 <br /> FEE <br /> INFO AMOUNT DUE AMOUNT REMITTED CASH RECEIVED BY DATE f]� PERMIT"NO. <br /> + EH 14-25 V.10183) VAI(� or <br /> EH 1428 UU <br />
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