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15602
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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VOLNEY
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3043
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4200/4300 - Liquid Waste/Water Well Permits
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15602
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Entry Properties
Last modified
12/2/2018 10:26:40 PM
Creation date
12/1/2017 11:01:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
15602
STREET_NUMBER
3043
STREET_NAME
VOLNEY
STREET_TYPE
ST
City
STOCKTON
SITE_LOCATION
3043 VOLNEY ST
RECEIVED_DATE
3/22/63
P_LOCATION
MRS C C LEE
Supplemental fields
FilePath
\MIGRATIONS\V\VOLNEY\3043\15602.PDF
QuestysFileName
15602
QuestysRecordID
1971180
QuestysRecordType
12
Tags
EHD - Public
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FOR OFF CE E: <br /> 3AC3. <br />--------------------------------------------------------- <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br /> (Complete in Duplicate) <br /> � ------------------ <br /> Date Issued •-------------- --� <br />-------- -------------------------------------- This Permit Expires 1 Year From Date Issued <br /> Application 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----- a�-I- A---------- »_..Y----------------------------------------------_------------------------------------------------------ <br /> i <br /> Owner's Name------- q--=---c ' ...I,ifJk-----........---------------------------. -------------------------- ------ Phone.. {e_1!'_3/I-,----------• i <br /> Address �:.-----►7+ ---------•-----------------------------------------------------------•---------------------------------....-------------------......------------------•---------------- <br /> Contractor's Name---------7: .:...P.6 AA_US_" --------I'vc= --•------------ --------------•--•--------------•----- Phone..../.fAll k4..7------- <br /> -- <br /> Installation <br /> will serve: Residence � Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: J.... Number of bedrooms .--�___ Number of baths .--/-_- Lot size ------- ------------------------- <br /> Water Supply: Public system El Community system ❑ Private ❑ Depth To Water Table ._Gp_ ft. <br /> 4 <br /> Character of soil to a depth of 3 feet: Sand ❑ -Gravel ❑ Sandy Loam ❑ Clay Loam [�" Clay ❑ Adobe ff Hardpan ❑ <br /> Previous Application Made: ;If yes,date--------------------) No Ff New Construction: Yes ❑ No Ef FHA/VA: Yes ❑ No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: + Q <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 /> ❑ No. of compartments--------------------------Size--------------------------------Liquid depth---------------- ---------Capacity------------- --------- <br /> Disposal Field: Distance from nearest welL./�IPnl _._Distance from foundation-----/.G_'___-____Distance to nearest lot line----.�'_•--- <br /> R9 Number of lines--------------1--------------------Length of each line----------SV._`.....-----Width of trench..-_------2;tY........... <br /> •--- <br /> Type of filter material-_- oe_.k---------Depth of filter material------1_15_"_'_____Total length--------------e(1_.'_________......--.- <br /> Seepage Pit: Distance to nearest well----------------------Distance from foundation---.................Distance to nearest lot line---.._______.._.. <br /> ❑ 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_________________________________ _ i e. <br /> ^ -------•----------------------------------------- <br /> Remodeling and/or repairing (describe):------------V-Q1>------raa -------- X!s 1tY :------SV.l - !'?•' --•-- .__-• <br /> --------------------------------------------------------- -•---------------------------------------------------------------------------------.------------------------------------_..._...---------------------- <br /> � 3 <br /> --------------------------------------------------------------- ---------------------------------- --------------------------------------------.1---------------------------------------------------- <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 Local Health District. <br /> (Signed)--------------d0-:-q....../ s ------- —----- -------------------�------------(Owner and/or Contractor) <br /> gY= = ----------------------------- {Title)------ �t' <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 /> AYRkATION ACCEPTED BY-- "'L <br /> DATE ---^---� � <br /> -- <br /> R+ EWED BY----------------------------------------A----- ------------------- --------------------------------- ---=------ DATE------------•---------•---------•-------------------------- <br /> BUILDINGPERMIT ISSUED----------------------------------------------------------------------------------------------------- DME------------------------------------- ----------------------- <br /> ✓' Alterations and/or recommendations:------------------------ ----------------------------------------------------------_--_-•-------•---------•---------------------------------_------------ <br /> ---------------------- <br /> ------------------------------ <br /> ----------••-------------------- ------ - -- <br /> 4Z ` <br /> FINAL INSPECTION BY:_-- -- ---� C yy�� , , Date------- �!--------.--�---------------�- <br /> ------------ ----- f <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 west Oak Street 124 Sycamore Street 205 West 9th Street <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> ES 9 REVISED 8-59 2M 5-62 ATLAS <br />
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