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20839
EnvironmentalHealth
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AHERN
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29050
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4200/4300 - Liquid Waste/Water Well Permits
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20839
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Entry Properties
Last modified
1/2/2019 10:06:53 PM
Creation date
3/20/2018 10:42:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
20839
STREET_NUMBER
29050
Direction
S
STREET_NAME
AHERN
STREET_TYPE
RD
City
TRACY
APN
25502069
SITE_LOCATION
29050 S AHERN RD
RECEIVED_DATE
07/14/1966
P_LOCATION
RAY MIZUNO
Supplemental fields
FilePath
\MIGRATIONS\A\AHERN\29050\20839.PDF
QuestysFileName
20839
QuestysRecordID
1632819
QuestysRecordType
12
Tags
EHD - Public
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VR VI rll.0 UJC; "- -•a.. <br /> __ , <br /> __ _. ...______.__ -------------- APPLICATION FOR SANITATION PERMIT Permit No. <br /> ------------------------ ---- (Complete in Duplicate) _ <br /> ------------- <br /> ------------------- This Permit Expires i YeaNFrom'baYe Iss!u�d ► Date Issued <br /> . . 2ss_ +r�2o- b9 <br /> Application is-hereby made to the San Joaquin Local Health District for a permit to onstruct install t work her�ndescribe <br /> This a .plica ation is made in compliance with County Ordinance No. 549. j &n" <br /> NZ <br /> JOB ADDRESS AND LOCATION•. ' r"�-"",� � " 0-0 --¢ <br /> Owner's Name----- __ Ajy4% 's <br /> - <br /> Phone <br /> �/ <br /> Addressr � �® Z. f ------------"------------- ------------------ <br /> Contractor's Name -- ------�----------- -------m---•-- � _---------------•-------- Phone._' 'ZA/P__N <br /> Installation will serve: Residence . Apartment House Commercial ero-�Court ❑ Motel ❑ Other ❑ <br /> P ❑ ❑ Trali <br /> Number of living units: _/_-__"Number of-bedroo sti' _ Num=ber of baths __ _,_A0t size __- <br /> Y Y. �J}� i € -- -- ---[Q ------------------------------- <br /> Water <br /> G--------- •----------- <br /> Water Supply: Public system ❑ Communit .;s s+em-,KPrivate D Depth to Water Table ___ ft. ; <br /> .9err: $ ,.�.. w�i94` � <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam E Claytlam ❑ Clay ❑ Adobe,K Hardpan ❑ <br /> . <br /> Previous Application Made: (If yes date---_----------------J NNew Constrluction Yes ❑ Noj�— FHA/VA: Yes ❑ No <br /> TYPE OF INSTALLATION AND.wSPECIFI,CATIONS: ._ <br /> (No septic +ank or cess�,,00l permitted if public sewer' is available,within'200 lef.) 000, <br /> zt <br /> Septic Tank: Distance fr m nearest well____ _________Dir+ s <br /> p = fiance frkomzfau�nda, Ion nn.Materlal__, -""_""--- - - --"----- ------------------ <br /> ,.� p _Sae q 4 p Capacity --------- <br /> tk) N of compartments Iai. u'Id de. th <br /> $. �# A_ <br /> Disposal Field: Diltance from nearest well -- Dis#ari�t`e from foundation -_ _ C}istnce to nearest lot line___ .. <br /> Number o'f'.lines___"__.__:___ � of3e • <br /> .� # + --_. gth ach line � a�A .Wider of trench__ '-------------------- <br /> Type <br /> . ---------- . <br /> Yp = Leth of filter materia __ <br /> T e of fitter material__ De r O__-v' Totallength-----1�" ----- q <br /> .f<nsr�:za+lllwr.�-1�' �� it �q <br /> morin �k O <br /> Seepage Pit: Distance to nearest well-_________________.__Dlstanee from'fouridatlon_" _...:_______Distance to nearest lot line ___-.______.__ ; <br /> ❑ Number olf�pits-----____________._._Lining material_.,e--_.__..t----..Size: Diamei-en»'".______ .__ Depth.......'' (r <br /> Cesspool: Distance m nearest well___i4 -"Distance,from�foundati,on„'".'.._. - - Lining turiaY----------- _ _ ------------------- <br /> Cesspool. <br /> _______ _______' � <br /> F] Size: Diameter. -Depth * _ _ ' "� uid C$ acit -.------- ------ ---. Is. <br /> ♦+ + �l ;i x� -- q y gals. <br /> Privy: - =Distance from nearest well _._._ ---- Distance from nearer 6 di - <br /> ❑ Distance to nearesiel6t*4ne _ _.._ __ - ----- - ---------- ---- --------------- - <br /> { <br /> alrindRemodelin and r scri _ <br /> lis _ •� __ <br /> -------------- -:----'------�-- -------------------- _ --- `”' -- ----------------V V. r � <br /> - ------------- ------------ --- <br /> I hereby certify that I have prepared this application and that the work will be' done in Sacco dance with San Joaquin County s <br /> ordinances, State laws) and rules_and_regulationstherSan Joaquin�Local-Health, istric+.., <br /> r . <br /> (Signed)--- <br /> (0 ner and,or-Con#rector r„ <br /> by---- --- ---- ----- - ------------ ` {Ti+le) <br /> .. _- -. - ----------------- ----- - -- ----- <br /> e� . i � . . ytR.a <br /> (Plot plan, showin eof lot,I _ tion flys+ems lotion }o wells; butldin s et *--caeplac`d on reverse side). <br /> FOR DEPARTMENT USE ONLY` <br /> APPLICATION ACCEPTED BY------------------------------------------------------------------------- ,f------ DATE--- <br /> - ` - <br /> - J <br /> REVIEWED t3Y' DATE "_--,/ € <br /> BUILDING PERMIT ISSUED- ---------- ------------------ ---------- -------------------- --- -- ---- -- ------.- DATE <br /> Alterations and/or recommendations:--------------.-------"-------------------------•--�- -------:_- /�- <br /> -------------------------------- ------- --"------------�----------------------- -------------------------------------------------- "----------- -------------•----------------------- ----------•------ ------------ <br /> FINAL INSPECTION 8Y: -- - -- Date-""-"-"- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E.Haxelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street <br /> Stockton,California Lodi, California Manteca,California Tracy,California <br />
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