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8036
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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8036
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Entry Properties
Last modified
7/4/2019 10:29:09 PM
Creation date
12/1/2017 9:29:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
8036
STREET_NUMBER
4
Direction
S
STREET_NAME
SINCLAIR
STREET_TYPE
ST
City
STOCKTON
SITE_LOCATION
4 S SINCLAIR ST
RECEIVED_DATE
09/20/1956
P_LOCATION
O L EPPERLY
Supplemental fields
FilePath
\MIGRATIONS\S\SINCLAIR\4\8036.PDF
QuestysFileName
8036
QuestysRecordID
1925114
QuestysRecordType
12
Tags
EHD - Public
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14 <br /> APPLICATION FOR SANITATION PERMIT Permit No. _. __ ..v.._ <br /> v (Complete in Duplicate) g YD I <br /> Date issued ----�-•---•_�� . <br /> Tglica}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. 549. < <br /> JOB ADDRESS AND LOCATION__________ __ _o.�__........ --Al C---�-I'/-- <br /> Owner's Name--------------- <br /> ---- ( �---------- -----p/�.orOK <br /> • -------------••-•----- ---- ---------- --- :------------------------------------ Phone------------------------------------ <br /> Address........-- /7-----------•----------- - I <br /> Contractor's Name......... a <br /> ------------------------------------------- Phone <br /> Installation will serve: Residence Er"'Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: ---/--- mber of bedrooms -..Number of baths ---/-- Lot size _-fi _�A-12-1¢_0_!-------------------- <br /> Water Supply: Public system- Community system .E] -Private ❑ -Depth to Water Tabler d ft. r <br /> Character of soil to a depth of 3 feet:t Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loa ❑ Clay ❑ Adobe[D--Hard pan ❑ <br /> Previous Application Made: Yes ❑ No [ New Construction: Yes [moo ❑ <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_f1p/✓#Disfance_frowfoundation_-.-/d..----_.Material._ / _!'-----------,- <br /> No. of compartments....rw ------- �Liquid depth-------6�- .--r___._Capacity_.,F__*_�_a_____.___ <br /> Disposal Field: Distance from nearest welily+<?.-.%X_Distance)rom foundation----_-�_ -.-..Distance to nearest lot line--3- ------ <br /> Number of lines-'----.-_-:�._� Le`ngth'Yof each line--------��__F...� -._.Width of trench----_xx1__S!�!.............. <br /> Type of filter material__.�I.1:__s'"il':Depth•of filter material__.._.�� Total length g ------------------- <br /> A <br /> Seepage Pit: Disfance to nearesf`well_.�?f�_ L__-Distance from foundation--_ Q__{.....Distance to nearest lot line__ a.-f._-_ <br /> Number of pits._.--� -------------Lining material_ "_i`G_/C.._.Size: Diameter---.. ------__--Depfn_.-.--- - ---------------- <br /> Cesspool: Distance from nearest well-----------------Distance from foundation..............:.....Lining material__..--_..___.____.__--_-.- ------ <br /> ❑ Size: Diameter--- --------------- Depfh-�-__-_"= ` '�-------- --------;----Liquid Capacity----------------------------gals. <br /> Privy: Distance from nearest well---------.-------------------------------------....Distance from nearest building.----------------------------------------- <br /> El Distance to nearest lot line----- ------------------ ---------------- --------------•--------- -£------- -------------------------------------------------------- <br /> Remodeling <br /> -- -Remodeling and/or. repairing (describe) w-� - ..y ------------------------------ ------- ------------------------------------------------- ! <br /> kl..io i <br /> - <br /> ------------------------------------------------------•------••-------••-•-----------------------------------------------------------------------•------------------ ---•---•- ------------ <br /> 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 LocallHealth District, <br /> r! S A/ <br /> (Signed)....._.. ... C- ----- - x er and/or Cont cfor) S <br /> XBy:------ --- ------ -----------------------(Title)--- <br /> (Plot 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 /> REVIEWEDBY--------------------------------------------- ---- ------ ----------------;--------------------------------------- DATE---------------�-- <br /> BUILDING PERMIT ISSUED------------------------- -- ••-------------------------- DATE--------------------•- j <br /> Alterations and/or recommendations:_------------- ' .----- <br /> • ---------------------------- ------ <br /> --- -- <br /> ----------- ----- 7n "-- ---- - ------ -- ---- :�r� .. <br /> ---------------- -- ---- ----------- . -- --- ::_ <br /> ----------------- ----- ------ ------------------------------------------------- --------------------------------------------- ------- ------• •------------------ <br /> FINAL INSPECTION BY:.______ <br /> ----------------------- Date. /.. <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 south American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street <br /> Stock+on, California Lodi, California Manfeca, California Tracy, California <br /> ES-9 745446 PTWOOP <br /> S <br />
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