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10528
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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26 (STATE ROUTE 26)
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19163
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4200/4300 - Liquid Waste/Water Well Permits
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10528
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Entry Properties
Last modified
11/20/2024 8:49:01 AM
Creation date
12/2/2017 12:11:24 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
10528
STREET_NUMBER
19163
Direction
E
STREET_NAME
STATE ROUTE 26
City
LINDEN
APN
09127015
SITE_LOCATION
19163 E HWY 26
RECEIVED_DATE
01/22/1959
P_LOCATION
LINDEN COMM METHODIST CHURCH
Supplemental fields
FilePath
\MIGRATIONS\T\26 (HWY 26)\19163\10528.PDF
QuestysFileName
10528
QuestysRecordID
1960245
QuestysRecordType
12
Tags
EHD - Public
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i <br /> f� , APPLICATION FOR rn D NII ATION PERMIT Permit No. _______________ <br /> t� Duplicate) Date Issued <br /> ll <br /> Application is hereby made to the San.Joaquin Local Health District fora permit to consteuct and install the work herein described. <br /> This application is made.in-compile ce with County Ordinance No. 549. ,J: b" -2"7 8-1 NOr,,,ff Of <br /> JOB ADDRESS D,LOCATION._ #-SS,<-o h" b �� '�'`� ------ ----... <br /> Owner's Name -x4 --11-1 e + -- �:_ _ <br /> ------------- -------------------- <br /> --- -- -� Phone--����7 <br /> Address__. j " <br /> 46t <br /> Contractor's Name_ r- c <br /> Installation will serve: Residence [] 'Apartment 1-louse❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other <br /> Number of living units: :__`___ Number of bedrooms________ Number of baths -------- Lot size --- 'Q __. ------ •,1----0-------------- <br /> Wafer <br /> f____-.---_Water Supply: Public system"' Commuriity system ❑" Private ❑ -Depth to Water Table. Q"ff:' <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam 0 Clay ❑ Adobe ardpan ❑ <br /> r <br /> Previous Application Made: "Yes ❑ No ❑ New Construction: Yes ❑ No ❑ FHA/VA: Yes 0 No B-7qd _ <br /> TYPE OF INSTALLATION-AND SPECIFICATIONS: <br /> {No septic tank or'cesspool permitted if public sewer is available within•200 feet. j. <br /> w <br /> Sepfic Tank: Distance from nearest well-Tto_"rve_____Distance from foundation;id�'2f__:-_,__.Material-_____-.___ __ <br /> ` No. of com"artmenfs__. - if <br /> .: , P -�- - - ----Size��---�-�'------•---Liquid�•depth_�` - �------Capacity----• -��--- - <br /> Disposal Field: Distance from nearest well.AmLl.Distance from foundation____AQ----o---- to nearest lot line............ <br /> Number of lines------I-------- t ` g ' �- ---.------.Width of trench------4c A'----------------- <br /> Type <br /> --._-- <br /> _______________Length of each line_____ • _-_-- <br /> Type of filter material_.._ Depth of.filter material-------let-____Total length_:--------------_�i�_*_________._ -5 <br /> Seepage Pit: " ' -Dist nce'to nearest vrell_'Ai tj._____r_Distance from"founds+ion......70___.-..Distanc`e to 6e8r6st.lof line------ <br /> Number of ------------Lining material_PWr1----------Size: Diameter---Z,3-"/-------Depth------- ................... ry <br /> Cesspool: Distance from nearest well------------------Distance from foundation--------------------Lining material------.----------,_-------------------"'(I} <br /> ❑ Size: Diameter--- ?-='----------- ------_Depth-------"----=----=-------------------------- `-----Liquid Capacity --gals! . <br /> Privy: Distance from nearest well--------------------------------__-____--__.__-_Distance from nearest building_____._______-_-___--.------------------- <br /> El _� :.,.. Distance-to nearest-lot line---`.,. --••---------- ----------------------- -- =------------------- <br /> Remodeling and/or 1pai6ng (describe):__ _-_e ----A a_� .� <br /> �[/J�r ,�,�-./e� , . <br /> --------------- <br /> ----------- <br /> --- - -- <br /> ------------ .... ..... ----------------------------------------------- <br /> /� ---------------------------- <br /> `--------"------------------------}---------------2------•-•----; ----��f.. l_'�ff/tz-----,/C� R �w�.'�n-4t ALIS �t/tom ----------•---4•------------------------ <br /> ----------------------------------------------- --------------- <br /> S <br /> I hereby certify that I:have prepared this application and that the work will"6e done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San Jo quip Local Health District. <br /> (Signed - �� l-�' Fyl�/_��L4 Contractor) <br /> Plot fan,-s------ size of lot, location of system in rela {Title�_....-----.-•--------------------------------------•'_-----"---- <br /> B <br /> [ p g y do wells, buildin , etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY. ---------------------------------- --------------------------..----------------------- DATE_ -__..__.. - r <br /> REVIEWEDBY------------------------------ ----- --------------------I------------------------------------------------------------ DATE__- z-. ------ <br /> BUILDING <br /> ----BUILDING PERMIT ISSUED------- '--------------------------------------------•--------------------------------. DATE-----�"' <br /> Alterations and/or recommendations-------------------------------------------------------------------•--- -----------------------------_ 6 <br /> a <br /> r <br /> FINAL-INSPECTION, BY:—_ =---------- =- _ - Date.:........ t`""� sYt --------"---------- <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 /> E5--4•--21vI Revised 1-57 F.P.CO. �.- <br />
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