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73-765
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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AIRPORT
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18097
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4200/4300 - Liquid Waste/Water Well Permits
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73-765
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Entry Properties
Last modified
4/6/2019 10:05:02 PM
Creation date
3/20/2018 11:02:20 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
73-765
PE
4211
STREET_NUMBER
18097
Direction
S
STREET_NAME
AIRPORT
STREET_TYPE
WY
City
MANTECA
SITE_LOCATION
18097 S AIRPORT WY MANTECA
RECEIVED_DATE
08/30/1973
P_LOCATION
GLEN ERVIN
Supplemental fields
FilePath
\MIGRATIONS\A\AIRPORT\18097\73-765.PDF
QuestysFileName
73-765
QuestysRecordID
1633431
QuestysRecordType
12
Tags
EHD - Public
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r <br /> FOR OFFICE USE: APPLICATION FOR 'SANITATION PERMIT <br /> ------------------------------------- <br /> (Complete in Triplicate) Permit No: <br /> ---------=---------------------------- <br /> �:_�" <br /> �3 <br /> _-___________.__________-___-_____-______________-t his Permit Expires 1 Year From Date Issued Date Issued _-- <br /> Application is hereby made to the San Joaquin Local Health District for a per to construct and install the work herein <br /> described. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: <br /> JOB ADDRESS/L06ATION .___/, © _____�-_______ _ _I__ _Q_ _" _.__-------___-_CENSUS TRACT -. .?_.� 1 <br /> Owner's Name = -� / - -------Phone -------------_ ------- <br /> pJig <br /> Address _C?7------- � Q R - City -�C ................................ <br /> Contractor's Name ------bq_ViI_/ .E -------------------------------------------------------License # ------------------------ Phone --------------• ----------- - <br /> Installation will serve: Residence [!J�partment House-E] Commercial ❑Trailer Court l❑ <br /> Motel ❑Other ------------------------------------------ <br /> 1 d t <br /> Number of living units:---1_ ..__ Number of bedrooms __ arbage Grinde% Lot Size <br /> Water Supply: Public System;arid name -------------------------- ------------------------------------------ --------- ---=------ -------Private. <br /> Character of soil to a depth of 3 feet: Sand'❑ Silt[] Clay ❑ Peat Sandy Loam Clay Loam;❑ <br /> Hardpan Adobe Fill Material -IV------ If y)olr <br /> (Plot plan, showing size of lot, location of system relation to Wells, buildings, etc:_,must be placed on reverse side.) <br /> NEW INSTALLATION: (No septic tank or seep a pit permitted if public sewer is available,within 200 feet,) p� 14L <br /> PACKAGE TREATMENT [ ] SEPTIC TANK,[ Size:___ ___, 5.....X__�S'--_______- Liquid Depth __7l?--------_--- <br /> 0 .. <br /> Capacity _� Q Q Type _-j _1_E0 9 material�NeKT No. Compartments _ -_ .. <br /> - 00 <br /> istance to nearest: Well ---------,'� '-�r"l`=-----Foundation -_/__®_'' _ Prop. Line __ ._�.......__ U <br /> LEACHING LINE No. of Lines _- _-________ Length of each line___��_ ----------- Total Length __/_� �.----.__.__ J <br /> r� <br /> 'D' Bo/etof2arest: <br /> Type Filter Material 4'1 CK.__Depth Filter Material __-__l_41'--------------I__-_.__-____-- <br /> �� �, <br /> Distan Well _ ___ __`"}--Foundation _ __ __ _ ___________ Property Line _-__-___..__..____._____ , <br /> SEEPAGE PIT [ J Depth -------------------- Diameter ---------------- Number ---------------------------- Rock Filled Yes ❑ No C] <br /> .Water Table Depth -------------------------------------- -..........Rock Size --------------------------------- <br /> Distance <br /> =-- ------Distance to nearest: Well --------------------_--------------------Foundation -------------------- Prop. Line ....-_..._._.__.._._... <br /> 0 <br /> REPAIR/ADDITION(Prev. Sanitation Permit# ____________________________________________ Date ___-____;_____---.__________----) <br /> SepticTank (Specify Requirements) ------------------------------------------------ -----------------------------------------------------------_ --------------------------- <br /> Disposal Field (Specify Requirements) -----------_ --------------------------------------------------------------- <br /> - ----- - ---- ----- <br /> ----- ------- ------- --------------- -- <br /> --------------------------------------- <br /> (Draw existinq and required addition on reverse side) <br /> .W, <br /> I hereby certify that I have prepared thil.application and that the work will be done in accordance with San Joaquin <br /> County Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local Health District. Home owner or licen- <br /> sed agents si nature certifies the following: <br /> "I certify t i the performance of the work for which this permit is issued, I shall not employ any person in such manner <br /> as to be co 'no <br /> to rkman's Itompensatron laws of California." <br /> Signed D - Owner <br /> BY - - -- ---- ---- : Title (,�'� i,- <br /> (If other than owner) <br /> /� FOR DEPARTMENT USE ONLY <br /> --I- 13- _. <br /> APPLICATION ACCEPTED BY ---- 0----------------------------------------------------------------------------- DATE ---- <br /> BUILDING PERMIT ISSUED ------------------- ---------------------DATE ------------------------------------------- <br /> ADDITIONALCOMMENTS ---------------- -- ---------------------------- -------------------------------------------------------------------------------- --------------------------- <br /> ----------------------------------------- ------ ----- - --------------------- --- ----------------------- ----------------------------------------------- ------ <br /> ------------------------------------ ----------- -------------------- - --- ------ ------- - ------------- ------------- <br /> - - --------- ---- <br /> -------------------- ------------ --- ------ --- --- ----- --- ------- --------------------------------- f <br /> Final Inspection ----- -- ------------ --- -------------------------Date ------ - <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> E. H. 9 1-'68 Rev. 5M <br />
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