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2743
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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2743
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Entry Properties
Last modified
1/14/2019 10:07:08 PM
Creation date
12/1/2017 5:12:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
2743
STREET_NUMBER
343
Direction
W
STREET_NAME
PEARL
STREET_TYPE
AVE
City
STOCKTON
SITE_LOCATION
343 W PEARL AVE
RECEIVED_DATE
07/08/1952
P_LOCATION
THELMA CARPENTER
Supplemental fields
FilePath
\MIGRATIONS\P\PEARL\343\2743.PDF
QuestysFileName
2743
QuestysRecordID
1895537
QuestysRecordType
12
Tags
EHD - Public
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APPLICATION FOR SANITATION PERMIT Permit No. ---------- <br /> (Complete in Duplicate) Date Issued <br /> Application is hereby made to the San Joaquin Local Health D;strA' for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordi/na ce 49. <br /> Ar' <br /> JOB ADDRESS AND LOCATION---- <br /> Owner's Name-----------------------------•-•-- ---------- ---- ------------- ------------------------------- Phone <br /> Address---------------------------------------------------- ------------------------------------- <br /> -------------------------- -------------- <br /> fl <br /> ------------- Phone...� 4�---------- <br /> Contractor's Name-----------I------ _eq <br /> Installation will serve: , Resicler!'cejg Apartment House El Commercial ❑ Trailer Court [] Motel [] Other 0 <br /> V <br /> _10 <br /> Number of living units:1----- Number of bedrooms I-' Number of baths Lot size ---60---- --------------- <br /> ----------- <br /> Wafer Supply: Public system Ej Community system E-] Private g Depth to Wafer Table/011", ft. <br /> Character of soil to a depth of 3 feet: Sand E] Gravel El Sandy LoamEClay Loam ❑1Ciay ❑ Adobe <br /> kf Hardpan,E] <br /> Previous Application Made: Yes ❑ NT,14- New Construction: Yes9 No F] <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> --(No septic tank or cesspool permitted if pUolic sewer is available within 200 fpet.) <br /> Sepfic,Tank: Distance from nearest wel&_0--------Distance from fou rlltlationX�----------Material -------- -- <br /> ---- Capacity____ <br /> No. of compartments--I-- _6_X_"�quid depf1n.c§__;Z............. <br /> L ------;41------ <br /> -------------------Size,�M <br /> Disposal Field: Distance from nearest _---Distance from foundation--2-S-- ---Distance to nearest lot line/0. <br /> 17- ------------- Width of ffench <br /> Number of lines--------- Length of each line--,, <br /> Type of filter material-A-_ A--- -.f" <br /> ---- ---4--Depth of filter materia!___ -------Total length---c-7-D__________________________- <br /> 7" - f t nearest lot <br /> Seep) Pit: Distance to nearest well_tP(O-'-----Distance from founclafion,�J-----------D�s tante o a <br /> Number of pits_____/____________Lining material -------------- <br /> ---Size: D;a met Depth-/ ------- <br /> Cesspool: Distance from nearest well-----------------Distance from founclation--------------------Lining material-------------------------------------- <br /> ❑ Size: Diameter--------------------------------------Depth-------------------------------------- -------------Liquid Capacity---------------------------gals. <br /> Privy; Distance from nearest well--------------------------------------------- --Distance from nearest building----------_-----------------_---- -----. <br /> ❑ <br /> uilding----------------------------------------- <br /> nDisfance to nearest lot kne----------------------------------------------------------------------------------------------------------------------------------------------- <br /> Remodeling and/or repairing. (clescribe):------------------------------------------------------------------------------------------------------------------------------- ------------------------- <br /> -------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------- <br /> ------------ <br /> ------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------r---------------------------- <br /> ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ <br /> I hereby certify that I h .v prepared this ap lication and hat the work will be done in accordance with San Joaquin County <br /> I h " a jpI the uin Local Health District. <br /> ordinances, State laws, and �Ule and ulations f a S n J aq <br /> P <br /> - ----- -- --- -A ------- --------- <br /> (Signed)-------------------------- - --------------------------------- - ------- Contractor) <br /> ---- ----- - <br /> Title--- -------------- -- ---- -------------------- <br /> ....... ....1�--------------------------------------------------------------------------T <br /> itize �� <br /> '(Plot plan, sl� ing size of lot, lo�caf�iko of system in relation to wells, buildings, etc., can be pt ced on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY------------- ----------------------------- Ve <br /> ---------------------------- DATE-------------7/7 <br /> - <br /> ------.-.-.-.-.-.-.--..-.-.-.-.-.-.-.-.-. <br /> --- ----- <br /> REVIEWEDBY------------------------- --------------------------------------------------------------------------------------------------- DATE---------------- ------------ <br /> BUILDING - <br /> PERMIT ISSUED------------------------------------------------------------------------------------------------------- DATE------------------------------------------------------------- <br /> Alterationsand/or recommendations----------- ---------------------------------------------------------------- ----------------------------------------------------------------------------------- <br /> --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------.........--------------- <br /> ----------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> ------------------------------------------------------------------------------------------------------------------- <br /> ---------------------------------------------- <br /> ----------------------11------------ <br /> ------------------------------------------------m------------------------- ------------------------------------- ------------------------------- --- ----------------------------------------------------------------------- <br /> P_W'_ 07,2 -------------------------------------------------- <br /> Da--------- <br /> FINAL INSPECTION BY:.*_ _1 ------- ------------- <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 B-51 Revised W-21DO <br />
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