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5633
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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POPLAR
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2339
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4200/4300 - Liquid Waste/Water Well Permits
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5633
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Entry Properties
Last modified
1/30/2019 11:52:53 AM
Creation date
12/1/2017 6:03:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
5633
STREET_NUMBER
2339
Direction
E
STREET_NAME
POPLAR
STREET_TYPE
ST
City
STOCKTON
SITE_LOCATION
2339 E POPLAR ST
RECEIVED_DATE
10/6/1954
P_LOCATION
G R DANVER
Supplemental fields
FilePath
\MIGRATIONS\P\POPLAR\2339\5633.PDF
QuestysFileName
5633
QuestysRecordID
1901509
QuestysRecordType
12
Tags
EHD - Public
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APPLICATION FOR SANITATION PERMIT Permit ✓ 1O 3� <br /> (Complete in Duplicate) <br /> Date Issued - <br /> Applica{ion is hereby made to the San 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. �54JOB ADDRESS AND LOCAN U ------ - <br /> o�✓ --- <br /> Owner's Name--<-3A! --- Phone-- " �• <br /> q - •-- - <br /> Address-----. - ..Qk- ..-... e <br /> - �/-- -------------------------- <br /> Contractor's Name---- -----• - ----- ---------------- Phone.Moo--- <br /> Installation will serve: Residence 20--Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: __-;/--- Number of bedrooms _-Z. Number of baths .� Lot size _ <br /> Water Supply: Public system Community system ❑ Private ❑ Depth to Water Table -------- ft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam E❑ Clay ❑ Adobe [ lardpan ❑ <br /> Previous Application Made: Yes ❑ No 9�-New Construction: Yes p No 2¢— <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-------------------Material-----__-----.____----__------__---____---___---. <br /> 0-7 No. of compartments--------------------------Size---•--------------- ----------.Liquid depth-------------------------Capacity----------------------- <br /> or <br /> Disposal Fiel : Distance from nearest well.01%vrs.C-_Distance from foundation------49-------Distance to nearest lot line---11 <br /> Number of lines------------ ---------- <br /> - ---- ---Length of each line------- -�{"!------_----.Width of trench----�V-�'----------__---- <br /> Type of filter material--1- IIS t Depth of filter material______ _ _________To+al length--------- _�.---_____---__._-__-_ <br /> y „ <br /> a----A <br /> Seepage Pit: Distance to nearest well-----------------------Distance from foundation--------------------Distance to nearest lot line----------------- <br /> 1-1 Number of pits;---------------------Lining material----------.------------Size: Diameter-----------------------Depth--------------------------------- <br /> Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material---____-_--------____-_----_---_-___ <br /> ❑ Size: Diameter--------------------------------------Depth----------------------------------------------------Liquid Capacity- ------------------------gals. <br /> Privy: Distance from nearest well-------------------------------------------------Distance from nearest building <br /> ❑ Distance to nearest lot line----------- <br /> ------------------------------ <br /> _ ------------------------------------- <br /> Remodeling and/or repairing (describe):--- . <br /> J <br /> ---------•-•------------------------------------------------------ -- <br /> -------------------------------------------------------------------------------------------------------------------------------------------»_._--_-__.___-__--__-_.___--____.------------------------------------------------ <br /> I hereby certify that 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 /> (Signed) ` - , Contractor)- -- ------- -BY:.....-= --------------- Tale------- <br /> P of plan, showing size,of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY -- ---- - ----- ---------------- ------------------------------------------- DATE------------- - -- <br /> REVIEWED BY----------•--------------------------- C� [� -•---- <br /> DATE -- ----- <br /> LIILDING PERMIT ISSUED--------------•----- --- ----- ----------------------------------- DATE-------------------- <br /> ---------------------- <br /> A ----------- <br /> Alterations and/or recommendations:--______________ <br /> -------------- -------- -------------------- <br /> ------------------- <br /> FINAL INSPECTION BY:-----------1 �3Y jC' /d 7 <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-4-2M Revised W-2100 <br />
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