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76-247
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ALAMEDA
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4200/4300 - Liquid Waste/Water Well Permits
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76-247
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Entry Properties
Last modified
5/4/2019 10:06:31 PM
Creation date
3/20/2018 11:24:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
76-247
PE
4211
STREET_NUMBER
648
Direction
E
STREET_NAME
ALAMEDA
STREET_TYPE
ST
City
MANTECA
SITE_LOCATION
648 E ALAMEDA ST MANTECA
RECEIVED_DATE
03/23/1976
P_LOCATION
LEONARD MEANS
Supplemental fields
FilePath
\MIGRATIONS\A\ALAMEDA\648\76-247.PDF
QuestysFileName
76-247
QuestysRecordID
1636649
QuestysRecordType
12
Tags
EHD - Public
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FOR OFF CE USE: \„ <br /> ' APPLICATION FOR SANITATION PERMIT <br /> •f SD� <br /> `t ICampleto In Triplicab) Permit No. 7-....... .. <br /> ......................................................... This Permit Expires 1 Year From Date Issued <br /> Date Issued ' : <br /> Application is hereby made to the San.Joaquin Local Health District for a permit 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/LOCATION ......�r�. Q__.. ,.L./..... L ,O�I.� ....- /.....................CENSUS TRACT .......,.................. <br /> Owner's Name ' ...._. ......................................................Phone <br /> . ... <br /> Address . . s %.. <br /> '1�.,��...�i...................... cityT.�C_p,sf.. ................ <br /> ..........t.`---...-- <br /> Contractor's Name ./ TE' -._P 61.Al,,(J'/lilo.....n. .......License# ���?��'/d... Phone �•��-�T..�� <br /> Installation will serve: Residence 9?1(partment House❑ Commercial Cffrailer Court ❑ <br /> Motel 0 Other <br /> ...................... <br /> Number of living units:.._/..... Number of bedrooms ..t- .....Garbage Grinder ............ Lot Size ............................................ <br /> Water Supply: Public System and name ----•.............................._...............................................•-----....................Private <br /> Character of soil to a depth of 3 feet: Sand`Silt❑ Clay ❑ Peat 0 Sandy Loam Clay loam ❑ <br /> Hardpan[] Adobe ❑ Fill Materlat ....- - Cf >t; ::............. ............ <br /> (Piot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side.) <br /> NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is avollable within 240 feet,) <br /> PACKAGE TREATMENT [ ] SEPTIC TAP <br /> ) Size... 1?°. ...................... Liquid Depth .......................... <br /> Capacity % -.. Type - -... Material...................... No. Compartments ...................... <br /> Distance to nearest: Well _ ... .....................Foundption !D ` Prop. Line ...................... <br /> }.....5 .......... 45 <br /> LEACHING LINE [ ] No. of Lines -�.................. Length of each line.. .BGS .:. Total Length a.ZPd................x <br /> 'D' Box ............. Type Filter Material ...................Depth Filter Material ............................................00 <br /> Distance to nearest: Well ........................ Foundation ....................... Property Line .......................�I <br /> SEEPAGE PIT [ ) Depth .................... Diameter ..............-,,-Number ............................ Rock Filled Yes ❑ No ❑1 <br /> Water Table Depth .................. .Rock Size ................................ <br /> Distance to nearest: Wel( .......... ............................Foundation ----- .............. Prop. Line ..................... <br /> A <br /> REPAIR/ADDITION(Prev. Sanitation Permit# .............-----__....................... Date .................................. <br /> ) <br /> Septic Tank (Specify Requirements) ...:..-......kaOV...... ..............................................I......................... ......M <br /> Disposal Field (Specify Requirements) ..... <br /> r4Q-�^ G7` �,r -210 <br /> ------------ ------------------------- ------ --------------------------------•------------•-•--•-----------.........------•-•---.....................---- ............................... <br /> ............... ------------------------ ----------------------- -----------------•---- .................-............................................................................................ <br /> (Draw existing and required addition on reverse side) <br /> 1 hereby certify that I have prepared this 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 itan- <br /> sed agents signature certifies the following: <br /> "I certify #hot in the performance of the work for which this permit Is Issued, I shalt not employ any person in such manner <br /> as to become subject to Workman's Compensation laws of California." <br /> Signe - .. Owner <br /> BY <br /> - - -- ..-� ----f-��11�Z�-•c.•�/�1�'..�3itle - -.�.10/Il�/C�G'.TD�.-����G'�`�...-.. <br /> (If of er than owner) <br /> __- -R DEPARTMENT USE ONLY ' <br /> APPLICATION ACCEPTED BY . .. ... .------------ -- - - DATE <br /> BUILDING PERMIT ISSUED _s.- .. ..•._,. <br /> ADDITIONAL COMMENTS -----. . . .. <br /> ------- ------- -------- -------_...._. <br /> .......... ...................... ................................._....................................... .. <br /> ----------------------- ----- ....... ... ----------- ....... _.... - <br /> . <br /> Final Inspection by: ...- 1. . -----------------•--------------------•---.......;...Date .. ..'_...... .�6...!......---- <br /> 3 2h 1-613 Rev. 5M SAN .LOA IN LOCAL HEALTH DISTRICT 8/7h 3M <br />
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