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12162
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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BRADFORD
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2035
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4200/4300 - Liquid Waste/Water Well Permits
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12162
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Entry Properties
Last modified
10/27/2018 10:43:41 PM
Creation date
12/5/2017 10:27:24 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
12162
PE
4210
STREET_NUMBER
2035
STREET_NAME
BRADFORD
SITE_LOCATION
2035 BRADFORD
RECEIVED_DATE
07/20/1960
P_LOCATION
RUSSELL DIETRICH
Supplemental fields
FilePath
\MIGRATIONS\B\BRADFORD\2035\12162.PDF
QuestysFileName
12162
QuestysRecordID
1667350
QuestysRecordType
12
Tags
EHD - Public
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APPLICATION FOR SANITATION PERMIT Permit Na. ...l-z.L ..Z <br /> 1 {Complete in Duplicatel <br /> Date Issued __-717_61-0 <br /> 6nVishergey <br /> This Permit Ex fres 1 Year From Date IssuedApplicatimade to the San Joaquin Lora! Health District fora ermit to nstruct and install work 9 p st I the herein described. <br /> This application is made in compliance with County Ordinance No. 549. y <br /> f T T <br /> JOBADDRESS AND. CATION----------- _ �-~--- --- - - ---- -- ------ - -------- -----------•-------••---•----------------------------------- <br /> ' r <br /> Owner's Name " L-1 = --- --------------------------------------- Phone------------------------------------ <br /> PIP <br /> ----------------- ------------------------------------------------------------------------- --------..---- <br /> Contractor's Name---------------------------------•- � f� <br /> --r� --------------------------------------- PhoneeCn �'�'r� <br /> Installation will serve: Residence �partment House ❑ Commercial ❑ Trailer}Court ❑ Motel ❑ Other ❑ + <br /> . f � <br /> Number of living units: __ Number of bedrooms - ---------- <br /> g � Number of baths _�___ Lot size"_----1, _�S��T-_�_-_--------------------- <br /> Water <br /> -__--_ <br /> Water Supply: Public system �ommunity system ❑ private ❑ Depth to Water Table '.yam ft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ElSandy Loam ❑ Clay Loam E] Clay E] Adobe Hardpan E]Previous Application Made: Yes E] No ew Construction: Yes ❑ No D�A/VA: Yes ❑ No ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: , ! <br /> r (No septic tank or cesspool permitted if public sewer is'available within 200 feet.) <br /> Sdp ic`T Distance from nearest well-----------------Distance from foundation--------------------Material------------------------------------------------- <br /> No. of compartments- ------.Size--------------------------------Liquid dep. h------------ -- ---------.Capacity---------------------- <br /> Distance from nearest welhlDistance from foundation---�--------Distance to nearest lot line---- ... <br /> Number of lines___--_----.- Len th of each line-----. -- - <br /> ®_ 9 fi Width of trench.-__,7-_ �---------------••- <br /> f <br />' Type of filter material-__-..-�-__--_ � Depth of filter material-.---��____-..Total length-------------� --__--_---_---_----- <br /> s �,'� / <br /> AQP ' Distance to nearest ell _Distance m f undationSZ�_----.Distace to nearest lot line----7`-_r__ <br /> Number of pits__.--V-.__--_____Lining material __.Size: Diameter._.�3-."/-----_.Depth----- f--------- <br /> Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material----..__--.--..--------.----------_-� (W� <br /> ❑ Size: Diameter--------------------------------------Depth----------------------------- -- ------------------Li Liquid Capacity_ gals. l <br /> q P tY- - ------------------- <br /> Privy: Distance from nearest well-------------------------------------------------Distance from nearest building--------_-.---.----_--______-_---__.-. <br /> Distance to"nearest":lot line--------------------------------------------- ------ - ----------------------------------------- - ------------------------ ---- <br /> Remodelingand/or repairing (describe)--------------------------------------------------------------------------•-------------•-----------------------------------------------•----------------- <br /> s <br /> ------------------------ ---- ---------------------------------------•--------------------------- ------------------------------------•--------------•----------------------------------------------------------------- <br /> I herpSfcer that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, acrd rules and regulations of the San Joaquin Local Health District.[Signed) ZLc r ------------- caner and/or Contractor) <br /> ,( <br /> BY=------ -•-----------------��-- '--- ----------------- --- --------------(Title)--------- - ---�-------------------- ------------ ------ <br /> ------------------------- <br /> (Plot <br /> plan, showing size of lot, location of system in relation wells, buildings, etc., can be' placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED} BY----- - - :_C-------_- _ DATE----__ _ <br /> 2 (J-r- <br /> REVIEWEDBY----------------------------------------- ------------------------------------------------------------------------------- DATE <br /> BUILDING PERMIT ISSUED--------- ---------------------------------------------------------------------------- -----• DATE--------------------------- <br /> Alterations and/or recommendations:---=------ <br /> - - ---------------------------------------- ---------------_------------------------------------------------------•--------- <br /> -------------------- --- •- <br /> - --------- <br /> ---------- <br /> ------------------- --:ZPd--- <br /> 49 <br /> ------------------------------- -----------------------•------ <br /> -------------------------------------------------------------------- <br /> FINAL INSPECTION .-- ...,- <br /> ` �! ------ Date---- <br /> BY: <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 /> ES-9-2M Revised 8-'59 F.P.Co. <br />
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