My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
72-275
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
S
>
SOUTH ORCHARD
>
9090
>
4200/4300 - Liquid Waste/Water Well Permits
>
72-275
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
3/5/2019 2:57:44 AM
Creation date
12/1/2017 10:08:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
72-725
STREET_NUMBER
9090
Direction
E
STREET_NAME
SOUTH ORCHARD
STREET_TYPE
RD
City
ACAMPO
SITE_LOCATION
9090 E SOUTH ORCHARD RD
RECEIVED_DATE
04/18/1972
P_LOCATION
GRAFFIGNA FRUIT CO
Supplemental fields
FilePath
\MIGRATIONS\S\SOUTH ORCHARD\9090\72-275.PDF
QuestysFileName
72-275
QuestysRecordID
1930521
QuestysRecordType
12
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
2
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
FOR OFFICE USE: APPLICATION FOR WELL OR PUMP PERMIT PERMIT N0. <br /> (Complete in TrDate Issued: - I74z ; <br /> T IS PERMIT EXPIRES l YEAR FROM DATE ISSUED <br /> APPLICATION IS HEREBY MADE TO THE SAN JOAQUIN LOCAL HEALTH DISTRICT FOR A PERMIT TO PERFORM <br /> THE WORK 'STATED HEREON. " THIS APPLICATION IS MADE IN COMPLIANCE WITH COUNTY ORDINANCE <br /> NO. 1862 AND RULES AND REGULATIONS OF THE SAN JO UI OCAL HEALTH DISTRICT. j <br /> JOB ADDRESS/LOCAT O C tJ Lv ENSUS TRACT: S4/ 1 <br /> OWNER'S NAME• PHONE: 36e's-, y:H <br /> ADDRESS: ^a CITY: <br /> CONTRACTOR S NAME: _ LICENS"4 PHONE: 6 0 <br /> INTENDED USE: INDIVIDUAL DOMESTIC ER WELL PUBLIC WATER WELL /—/ TEST WELL <br /> IRRIGATION/LIVESTOCK/AGRICULTURAL WATER WELL / /—INDUS—TRIAL WATER WELL / / <br /> CATHODIC PROTECTION WELL / / GEOPHYSICAL WELL / / OTHER <br />- �. -��w'Y N �swrwJmla: . .fele-' f,�- • i <br /> NEW WELL: DISTANCE TO NEAREST: SEPTIC TANKY SEWER LINES PIT,,PRIVY <br /> SEWAGE DISPOSAL FIELD CESSPOOL SEEPAGEJPIT .OTHER`,:' <br /> REPAIRS: TYPE OF REPAIRS: <br /> ABANDONMENT/DESTRUCTION: METHOD TO_BE USED: <br /> i <br /> r <br /> rPLOT PLAN: SHOW ON REVERSE SIDE <br /> I HEREBY`"CERTIFY-THAT-1 HAVE-PREPARED`-THIS'APPUICATION AND^THAT-THE'WORK-WILL�BE-DONE-I-N— <br /> ACCORDANCE WITH THE PROVISIONS OF THE-LAWS OF THE STATE OF CALIFORNIA, THE ORDINANCES OF THE <br /> COUNTY OF SAN JOAQUIN, AND THE RULES AND REGULATIONS OF THE SAN JOAQUIN LOCAL HEALTH DISTRICT. <br /> SIGNED: CONTRACTOR: <br /> e <br /> FOR DEPARTMENT USE ONLY <br /> PHASE I <br /> APPLICATION ACCEPTED BY: DATE: � a <br /> ADDITIONAL COMMENTS: <br /> i <br /> PHASE II PHASE III FINAL <br /> INSPECTION BY: DATE INSPECTION BY: DATEt. <br /> f E H 1426 SAN JOAQUIN LOCAL HEALTH DISTRICT 1/72 1M <br /> DISTRIBUTION: WHITE-HEALTH DISTRICT - YELLOW-PROPERTY OWNER - PINK-CONTRACTOR <br /> k - <br />
The URL can be used to link to this page
Your browser does not support the video tag.