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17500
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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17500
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Entry Properties
Last modified
12/16/2018 10:09:49 PM
Creation date
12/1/2017 5:32:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
17500
STREET_NUMBER
519
Direction
S
STREET_NAME
PERSHING
City
STOCKTON
SITE_LOCATION
419 S PERSHING
RECEIVED_DATE
05/29/1964
P_LOCATION
GUARANTEED HOMES
Supplemental fields
FilePath
\MIGRATIONS\P\PERSHING\519\17500.PDF
QuestysFileName
17500
QuestysRecordID
1898298
QuestysRecordType
12
Tags
EHD - Public
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f ' <br /> FOR OFFICE USE:A. <br /> ---------- <br /> APPLICATION FOR SANITATION PERMI <br /> Permit No. --� � '. <br /> fO' <br /> ___ �:3 -.- (Complete in Duplicate) Date Issued �_r_ �•`��� <br /> ----31 d-6 IThis Permit Expires 1 Year From Date Issued , <br /> ` Lica ion is hereb made to the S� Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> D---L-O----C-ATION- �JJ/ <br /> aJOB ADDRESS ' <br /> Owner's Name- -------- & ---------•- - <br /> ----- --- `Phone-----•--------------•----•--------- <br /> Address ....... <br /> ------ Phone <br /> -- ----------Contractor's Name--.00..... -------------------------------------- <br /> I <br /> Installation will serve: Residence �jfApartment House L3Commercial ❑ Trailer Court El Motel ❑ Ofher ❑ <br /> Number of living units: --- --- Number of bedrooms �----.Number-of baths ._-_ Lotrsize 4 _ .7 ✓-•---------------•--------------- <br /> Water Supply: Public system .:Community system ❑ Private ❑ Depth to Water Table _ ft. 1 <br /> Character of soil to a depth of 3 feet: -Sand ❑ Gael El Sandy Loam Clay Loam ❑ Clay ❑ Adobe❑ Hardpan C3 <br /> Previous Application Made: (If yes,date--- -- .---1 No [ New Construction: Yes �No ❑ FHA/VA: Yes ❑ No ®� <br /> s <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well-- .-_:_--_Distance from foundation-tO--------------Material----/-�'- .--------------------- <br /> ---- --- ---Size---`� �— -- ------ o -- <br /> -� Na. of com artments-__-.�--- --'�-�-_-- � Liquid depth-'---`x-'�-------'-'---CePacitY----,�Q-� - <br /> Disposal Field: Distance from nearest well.-- ..-- ----Distance from foundationl,D--------------- <br /> -------------Distance to nearest lot lines------------ <br /> I <br /> --__.-. <br /> Number of lines.211 Length'of each Gine--4�'- °__-� Width of trench _4- J <br /> ,! Type of filter material__o_C_k`.--------Depth of filter material-- .tr Total length_---/J- -f------------------------- <br /> 9 <br /> Seepage Pit: Distance to nearest ----J well__- ----_--_---Distance from foundation Ze-------------Distance to nearest lot line--.. _.-.------- <br /> Number <br /> - --.-Number of pits- : -------------Lining maferial-_T_ dGYC--_.Size: Diameter.-32.-------------Depth---rest well------- from.;foun3"'--_-----_--------- <br /> dation--------------------Lining.material--.-..--------------.-----_-.----_ <br /> Cesspool: Distance from nea <br /> ❑ Liquid Capacity f --gals. <br /> Size: Diameter- : ' ----- ep -------------------------------- m <br /> Privy:. Distance. rom..neares --_--------------------------------- - <br /> Distance to nearest lot;line..- --------- --------- 4---------- ------- ---------------------- ------------------------------- <br /> - eling and/or repairing (describe):----`---------------- ------------------------•------••----=-------:--------•--------=•-:-----•--•-------•--------------------- -------- -- <br /> Remad `- I --- ----------------------------------- ----------------------- --------------------- <br /> -- -------------------------- <br /> ----------------------------- - <br /> - ;_ I ------------------------- ------------------------------------------------------------------- ----- ------ <br /> -- --------------------------------------=----------------•----------------------------------------------------------------- <br /> I hereby certify tha+ I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San "Joaquin Local Health District. <br /> I _ --! <br /> - Contractor <br /> = -F (� <br /> # ----------(Title]-----a,r�.a,,G -------------- ------ - <br /> c�` ,- <br /> (Plot plan, showing size of lotjocation.of system in relation to wells, buildings, etc., can be placed on reverse side]. <br /> 1 <br /> r <br /> FOR DEPARTMENT USE ONLY <br /> i <br /> APPLICATIONACCEPTED BY-----F-' } �---------------------- ------------------------------ = DATE REVIEWED BY------------------------------------------ ------------- `---------- DATE----------------------------------------------------------"-W_-_ <br /> BUILDINGPERMIT ISSUED--------------- -------- ------------;---:---------•----•--------------------_' ---------- DATE----------------------------------------------- --- -- <br /> Alterations--a--n--d- <br /> nd/qr reco mendations:--..-':.--_-.--- Y <br /> ------•------------•-----------•--------------------------------------------------------------------- <br /> - <br /> - <br /> ----------------I/-------6---,-�-7--- --- --- ----------- _�e <br /> ----------•------ <br /> e e.----- ----------- <br /> �. -------' <br /> w <br /> __________________ ____ `___:: ` :_ ... -------------;-----------------------_---- -------------a--- ------ <br /> . . <br /> FINAL INSPECTION BY:.---'-' �.S .. Date------- ' ?-- ' ' <br /> � � SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E.Hazelton Ave. ' 300 West Oak Street 124 Sycamore Street 205 West 91h Street <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> 1 <br /> ES 9 REVISED 8-59 31A 3•'63 F.P-CD. <br />
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