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9504
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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33 (STATE ROUTE 33)
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31448
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4200/4300 - Liquid Waste/Water Well Permits
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9504
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Entry Properties
Last modified
11/20/2024 8:59:24 AM
Creation date
12/2/2017 12:24:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
9504
STREET_NUMBER
31448
Direction
S
STREET_NAME
STATE ROUTE 33
City
TRACY
APN
25531023
SITE_LOCATION
31448 S HWY 33
RECEIVED_DATE
1/21/1958
P_LOCATION
HENRY PETERMAN
Supplemental fields
FilePath
\MIGRATIONS\T\33 (HWY 33)\31448\9504.PDF
QuestysFileName
9504
QuestysRecordID
1961286
QuestysRecordType
12
Tags
EHD - Public
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APPLICATION FOR SANITATION PERMIT Permit No. --- .....11 <br /> (Complete in Duplicate) j/1--A <br /> Date Issued --- --•-- - __-- <br /> 2S'5'- 3/a .�73 <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. 544. <br /> JOB ADDRESS AND CATION l _ _ 1 !hlF ' f <br /> Owner's Name , jOt =--)•-------------------------------------------------- hone----------- <br /> Address E- T --rGr <br /> Contractor's Name--------!'.-- ---•-•----•---------------------------------------------------------------- --•-----------------•----- Phone._--------------_------------- <br /> Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: _ -- Number of bedrooms _ Number of baths _A--_ Lot size ----------------- <br /> Water Supply: Public system E] Community system ElPrivate Depth to Water Table _— it. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ° Adobe ❑ Hardpan ❑ <br /> Previous Application Made: Yes ❑ No x New Construction: Yes,x No ❑ FHA/VA: Yes ❑ No <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-- v--Distance from foundation --___ "-------Material <br /> "" - <br /> [' o. of compartments_____ - - 'Size- :yC-_y_ _._- iquid depth_--_" -1'-- r^'Capacity-_-- ------- -- <br /> Disposal Field: Distance from nearest, well--_570-_'Distance from foundation---- ± ------Distance to nearest lot lin --�..- (� <br /> Nu ber of lines--_-__- ------- ---- Length of each line_-_--- .� Width of trench.- V-1-1-1- ---------------- <br /> pe of filter material-_• _i___ -1 Depth of filter material---_. _ ---___-_-Total length--_-.--. - ___---__--------------- <br /> Seepage Pit: Distance to nearest well-----------------------Distance from foundation--------.___........Distance to nearest lot line---_------------_ <br /> Ll Number of pits----------------------Lining material-----------------------Size: Diameter------------------------Depth------------------.--------_----- <br /> Cesspool: Distance from nearest well-----------------Distance from foundation-------------------- 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 /> Remodeling and/or repairing (describe:_-. - •' � - ` -------' _ -'' _ r �t ' <br /> .� <br /> `�" -t• `'�`�'"' '------••------•--------------------- <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) -----i------- <br /> ----'--- �-'- --------------------------------------------------------------------------- Owner and/or Contractor( / ) <br /> Sy:---------------/----•--------------------------------------------------------------------------------------------------------------{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 /> REVIEWED BY-------------------------------- '� -?----------------------------------------------------- DATE----------- <br /> BUILDING PERMIT ISSUED----------------- ._ .r - _ -/-•----------------------------- --------- DATE-------- 1 --:7-- --- ----------.-_. <br /> -- <br /> Alterations and/or recommendations- ---------------------------------------------- _----------------------------------------------------------------------•-----------------------------•- <br /> ----------- ------------------------------•------- •------•----------------------------------------------------------------------------------------------•--..-...-...---------------------------------------------------- <br /> ---------- ----------------------•----------------- ----•------------------- ----------------------------- ---------•------------------ ....------------------------•-------..--.... <br /> ------- <br /> ---------------------------------------------------- __--.. - ---------- ---------------------------------------•------•--------------------------------- --------------------- -- ----- <br /> FINAL INSPECTION BY:. Date - <br /> SAN C <br /> 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-9-2M Revised 1.57 F.P.Co- <br />
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