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18520
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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18520
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Entry Properties
Last modified
12/21/2018 10:10:13 PM
Creation date
12/5/2017 6:31:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
18520
PE
4211
STREET_NUMBER
24
Direction
S
STREET_NAME
ANTHONY
STREET_TYPE
AVE
City
STOCKTON
SITE_LOCATION
24 S ANTHONY AVE STOCKTON
RECEIVED_DATE
02/23/1965
P_LOCATION
JAMES BROWN
Supplemental fields
FilePath
\MIGRATIONS\A\ANTHONY\24\18520.PDF
QuestysFileName
18520
QuestysRecordID
1643724
QuestysRecordType
12
Tags
EHD - Public
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FORIOFFICE USE: <br /> .. <br /> -S-- --o_a- APPLICATION FOR SANITATION PERMIT Permit No. .���.. --a <br />_---___.-__--�/�--------- --- -- - --- (Complete in Duplicate) �lz`' �6,$— <br /> This Permit Expires 1 Year From Date Issued Date Issued _.___-.....�,._..._. <br /> ---- --------- -- <br /> ----------------------- <br /> Application 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 /> JOB ADDRESS AND LOCATION ��HV^ <br /> �-7- <br /> Owner's Name----`�i ----- - ------ ------- --------------------------------------------------- ---------- Phone------------------------------------ <br /> }_ ----------------- <br /> --------- <br /> ----- <br /> PhonG ! - "2ZContractor's Name------------------------------------ ----- ------------- <br /> Installation <br /> will serve: Residence Q" Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: _-I..- Number of bedrooms __.-. Number of baths j-.-_ Lot size -------- _--------------------- <br /> r <br /> Water Supply: Public system 2- Community system ❑ Private ❑ Depth to Water Table ft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe Zr Hardpan ❑ <br /> Previous Application Made: (If yes,date_- ------ ---------) No [- New Construction: Yes ff- No ❑ FHA/VA: Yes ❑ No ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) / <br /> Septic Tank: Distance from nearest well_11WQ4_!9 Distance from foundation----f o---------Material----ke-----Y✓--- -?c----------------- <br /> No. of compartments.-.-._-_ --._.Size---- '-k _. ' _Liquid depth----- -------_._.----Capacity---- <br /> Disposal Field: Distance from nearest well- -.-Distance from foundation.. ,...--.._...Distance to nearest lot line----s�../.......� J <br /> [� Number of lines------..__.1---------------------Length of each line---------7.0..-------------Width of trench.---.Z -....-.-._....._.-_--_- <br /> Type of filter material- OQuc�----------Depth of filter material.--- k------------Total length------------�--------------------------- <br /> -s <br /> Seepage Pit: Distance to nearest well -'«-----Distance from foundation----Lv..........Distance to nearest lot line�.s.. .r.__.-. <br /> ®' Number of pits-----/--_._...-----Lining material-----/Q.,c/�---.Size: Diameter-----JA- --------Depth------?.s _._.-_.-_------- <br /> Cesspool: Distance from nearest well-------------....Distance from foundation--------------------Lining material------..__.-_-.----_-----.._.._--_-.. <br /> ❑ Size: Diameter--------------------------------------Depth--------------------- ------ --------------------.-Liquid Capacity------------•-----------....gals. <br /> Privy: Distance from nearest well -__-__------___---__-.-_--------------Distance from nearest building------------------------------------------ <br /> 171 Distance to nearest lot line---------------------------------------- ----------------------------------------------------------------------------------------------- <br /> Remodelingand/or repairing (describe):------------------------------------------------------------------------------------------------ ----------•----------------------------------------- <br /> ---•-•--------------------------------------------------------•-----------------------------------------------•----------------------------------•------------------- ------------------------------------------------------� <br /> --------------------- --------------------------------------------------------------------------•--------------------------------•---- ---------------•----------------------------------------------------- <br /> ------------ ------------ ---------------------------------------------------------------------------------------------•--------------------------•--------------------------------- ---------------- ------------ <br /> I hereby certify that 1 have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> (Signed)------------ ----------------------------------------------------------(Owner and/or Contractor) <br /> - ------------- - <br /> By:-------- --- ------- ----------------------------------------------------------------------------------------(Title)----- ------ ---------------------- ----- --------- <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> -11 APPLICATION ACCEPTED BY---------- "�-�-____I-------------- <br /> -=- =----------------- ----------------- ---------------------------------------- DATE.--�------- - ------ <br /> REVIEWEDBY--------------------------------------------- -------------------------------------------------------------------------------- DATE.---------------------------------------------------------- <br /> BUILDINGPERMIT ISSUED------------------------------------------- ------ DATE.-------------------- ---------------------------•---------- <br /> Alterations and/or recommendations: -------------- ---------- ----------------------------------------------- ----- - <br /> j- - <br /> ------------------------- y "' _3._:_4_..x-------------- a�----•-------------•----------•---------6-je-------------------------------------- ----------- --•--------•- <br /> -------------------------------------------------------- ---------------------- ---------------------------------------•--------------------------------------------------------------------------------------- ------- <br /> ----------------------------------•--------- -------------•------------------------- -•------------ ---------------- -------------- -------•---•----- -----•--•---------------------------------------------•-------- <br /> ----------- --------- ---------------- --•--------------------- -------------- -----------------------------•-------- ------------ ----------------------------------- <br /> FINALINSPECTION BY:-------- --C.'-------------------------- ---------- Date--------`----1- r--------'---------------------------------------:--------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> F.P.CO. <br />
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