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7081
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FRENCH CAMP
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4200/4300 - Liquid Waste/Water Well Permits
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7081
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Entry Properties
Last modified
2/20/2019 10:49:19 PM
Creation date
12/5/2017 4:34:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
7081
STREET_NUMBER
9009
Direction
S
STREET_NAME
GROVE TREE
STREET_TYPE
RD
City
STOCKTON
APN
19319008
SITE_LOCATION
9009 S GROVE TREE RD
RECEIVED_DATE
01/16/1956
P_LOCATION
NISHIDA BROS
Supplemental fields
FilePath
\MIGRATIONS\F\FRENCH CAMP\9009\7081.PDF
QuestysRecordID
1775106
Tags
EHD - Public
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y� APPLICATION FOR SANITATION PERMIT Permit No. .__��-��.. <br /> (Complete in Duplicate) <br /> Date Issued <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. Pq 3— 0 .. <br /> JOB ADDRESS AND LOCATION------- <br /> " _ , Q---------------- ------------------------------------------------------- ------------------ <br /> Phone <br /> ------- <br /> Owner's Name_-. = - - - <br /> Address = <br /> ----------- ------ - <br /> asY <br /> Contractor's Name-------------------+-• --------- :-- -------------- -------------- Phone. .... <br /> ----------------- <br /> Installation will serve: Residence ❑�partment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: =)____ Number of bedrooms __Number of baths /-T'/-- Lot size -------- a- - <br /> Water Supply: Public system ❑ Community system El Private Depth to Water Table �6 ft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam [Clay Loam ❑ Clay ❑ Adobe ❑. Hardpan ❑ <br /> Previous Application Made: Yes ❑ No ❑ New Construction: Yes ❑ No ❑: �-- <br /> - � r <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: 1 <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well---__.__) Distance from foundation__.` -- <br /> �_--- ��--------.Material------ <br /> ---- --- ------------------ ------ � <br /> No. of compartments.____._____ - ---Size_.__3 __ x�Liquid depth__.___.Vtf'---_-Capacity------ <br /> . d ... <br /> Disposal Field: Distance from nearest well._ .°.._Distance from foundation_._._' v_---Distance to nearest lot line_._-_ ... <br /> Number or r lines--------------� � , Length of each line <br /> ---------- ---,--- .Width of +ranch.-------f� �`r.------------- h <br /> Type of filter material. !._Depth of filter material--------- Total length------------------- <br /> Seepage Pit: Disiance•to nearest well------------------....Distance from foundation------------------- <br /> .Distance to nearest lot line----------------- <br /> ❑ Number of pits. -Lining material-----------------------Size: Diameter------------- ---------Depth--------------------------------- O <br /> Cesspool: Distance from nearest well-----------------Distance from foundation.........:..........Lining material--------------------------------- <br /> .__.-. <br /> Size: Diameter Deh-h_ �_ ..�....�x cquidYCa�aeity . --------.gays. �- <br /> well------ -------------------------- ---------------Distance from nearest building______ _______•______.._ -__._._. <br /> Privy: Distance from nearest <br /> Distance to nearest lot line - ------•--------•----------------------------------------- <br /> Remodeling and/or repairing (describe)------------------- --•-------------------•---------•--------.----------------------------•------------.- ------------- <br /> --------------•--------•-------•-------- ---------•--------------------------------------------------------- <br /> -- <br /> -------------------------------- ----------------------- ---•-------------------------------------------------------------------•-------•------••-------•---------------------------------------------------- <br /> hereby certify that l have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules d regulations of the San Joaquin Local Health District. <br /> wner anor Contractor <br /> (Signed}!_----••-��---••- --. '?� �"R"'>� ------------ <br /> -------------------- - -- (_Od� ) <br /> BY� / - - Title <br /> ( � le)------------------------------ --------------------------------- <br /> (Plot plan, showing size of lot, location of system in reEation to wells, buildings, etc., can be placed on reverse side]. <br /> FOR DEPARTMENT USE ONLY <br /> ----------------------- DATE---------- / ---------------- <br /> APPLICATION ACCEPTED BY.._____.--- . .. __ ---------- --- -- - G" <br /> REVIEWED BY----------------------------- ------------------------ DATE----------- --------------------•------------------------- <br /> - ---- ---- - ------------ --------- - - - ------ --------------- <br /> BUILDING PERMIT ISSUED-------------------- ----------- --------- DATE... <br /> Alterations and/or recommendations------------------ ------------------------------------•-------•---------------•-------------------------------- <br /> FINAL INSPECTION BY-------- ------------------------------- ---------- - -------- Date <br /> 1 ---------------------- <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 /> rrl -9-2M 145446 ATWPnD 12-54 <br />
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