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SAN •AQUIN COUNTY PUBLIC HEALTH VICES ENVIRONMENTAL HEALTH DIVISIO 445 N SAN JOAQUIN, PHONE (209)468-342 'M ' r P O BOX 2009, STOCKTON, CA 95201 J U L 3 1 1992 PERMIT EgPIRES 1 YEAR FROM DATE IS UID ENVIR�NMi i>` �.r�d (Complete in Triplicate) PERMIT/ L-lkVi(' `ry Application is hereby made to San Joaquin County for a permit to construct and/or install the work herein described. This application is made in compliance with San Joaquin County Ordinance No. 549 and 1862 and the Rules and Regulations of San Joaquin County Public Health Services. Job Address WEST OF 4447 SOUTH AIRPORT WAY City STOCKTON Lot Size/Acreage 25 ACRES—VACANT BILL BIRCH — Owner's Name SAN JOAQUIN STEEL CO. Address P.O. Box 8426, STOCKTON, CA 95208Phone 209 948 0541 GILES ENGINEERING ASSOCIATES, Inc. 4875 E. LaPalma Ave Contractor (DOUG DAYTON) (GEA) Address Ste.607, Anaheim, CA 9280license No. 647935 Phone 714 779 0052 , TYPE OF WELL/PUMP: NEW WELL ❑ WELL REPLACEMENT n DESTRUCTION O Out of Service Well ❑ . PUMP INSTALLATION O SYSTEM REPAIR O (BORINGS) OTHER IR Monitoring Well ❑ DISTANCE TO NEAREST: SEPTIC TANK SEWER LINES DISPOSAL FLO. PROP. LINE FOUNDATION AGRICULTURE WELL OTHER WELL PITS/SUMPS _ INTENDED USE TYPE OF WELL PROBLEM AREA CONSTRUCTION SPECIFICATIONS C3 Industrial ❑ Open Bottom O Manteca Dia. of OW Excavation Dia. of Well Casing [I Domestic/Private ❑ Gravel Pack ❑ Tracy Type of Casing_ *f Specifications 1.1 Public Cl Other fl Delta Depth of NONNOR Borings* 8 feetType of Grout I I Irrigation —Approx. Depth I I Eastern Surface Seal Installed by Rantoni tP Pallets , Repair Work Done U Type of Pump H.P. State Work Done_ Well Destruction O Well Diameter Sealing Material & Depth Depth Filler Material i Depth TYPE OF SEPTIC WORK: NEW INSTALLATION I I REI TEXP No,septic system permitted it public sewer is ai n 200 feet.) r"APMITFNC Installation will serve: Residence_ Commercial_ Other Number of living units: Number of bedrooms �ermlmay O pIred I � Character of soil to a depth of 3 feet: er table depth SEPTIC TANK ❑ Type/Mfg dompartments PKG. TREATMENT PLT.❑ y tAVIf0nrn,,. � � ,Method of Disposal Distance to nearest: Well Foundation l Orb Mine LEACHING LINE ❑ No. & Length of lines Total length/size FILTER BED ❑ Distance to nearest: Well Foundation Property Line SEEPAGE PITS I I Depth Size Number SUMPS LI Distance to nearest: Well Foundation Property Line DISPOSAL PONDS ❑ 1 hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin county ordinances, state laws, and rules and regulations of the San Joaquin County Home owner or licensed agent's signature certifies the following: "I certify that in the performance of the work for which this permit is issued, I shall not employ any person in such manner as to become subject to workman's compensation laws of California." Contractor's hiring or sub-contracting signature certifies the following: "I certify that in the performance of the work for which this permit is issued, 1 shall employ persons subject to workman's compensa- tion laws of California." The applica t ust call for allEd inspe, tions. Complete drawing on reverse side. Signed Title: t'_Y� - Date: R DEPARTMENT USE ONLY Application Accepted by Date Area for Pit or Grout Inspection by Date Final Inspection by Date Additional Comments: Applicant - Return all copies to: San Joaquin County Public Health Services Environmental Health Permit/Services 445 N San Joaquin, P O Box 2009, Stkn, CA 95201 FEE AMOUNT DUE AMOUNT REMITTED RECEIVED BY DATE PERMIT NO. INFO �yr� CASH �/�j� . EH 13-24(REV.1/Rsl 0, �JO ��19� I �' �� CA 11.26 v