My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
C
>
CHANNEL
>
0
>
2900 - Site Mitigation Program
>
PR0523718
>
SITE INFORMATION AND CORRESPONDENCE
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
2/14/2019 10:58:32 AM
Creation date
2/14/2019 10:39:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0523718
PE
2950
FACILITY_ID
FA0015997
FACILITY_NAME
SJ REGIONAL TRANSIT
STREET_NUMBER
0
STREET_NAME
CHANNEL
STREET_TYPE
ST
City
STOCKTON
Zip
95205
CURRENT_STATUS
01
SITE_LOCATION
0 CHANNEL ST
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
22
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
San Joaquin County <br /> Environmental Health Department SITE <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202 MITIGATION <br /> 0 <br /> (209)468-3449 Fax: (209)468-3433 Web: www.co.san-joaquin.ca.us/ehd UNIT IV <br /> NON-REFUNDABLE PERMIT EXPIRES 1 YEAR FROM DATE ISSUED <br /> Application is hereby made to San Joaquin County for a permit to construct and/or install the work described. This application is made in compliance with San <br /> Joaquin County Development Title,Chapter 9-1115.3 and the Standards of San Joaquin County Environmental Health Department. <br /> � r�t I ` Assessors <br /> Locatioy 4A�) fh► 4 t�O I41!37,ross Street City"L L N Zip 7�� Parcel# <br /> PROPERTY �— Disc— t ` � q 2 �^p� - 7 ` <br /> Owner nA WAJ Imo(,•j?4A- Address 163� *34- -idsk City AGI Zip 7 07 Phone# 1 ,7—Z 37 0 �5� 6 <br /> C-57 Contractor r Address 'b Vf�C 4e /� City ( 1 VL Zip UJ797Phone#G O—A( <br /> Consultant/Sub Cntr �. ��n/t(t_Address Z (� City �N Lic# Phone# / [ ��3 <br /> GIS Coordinates:X Y Township Range Section <br /> WORK TO BE PE <br /> 0 NEW / GRIN (CP , EOP E, DROPUNCH,HAND-AUGER,OTHER*) DESTRUCTION (choose type below) <br /> SOIL G# 0 OVER-BORE. DIAMETER <br /> 0 WELL# &PRESSURE GROUT <br /> 0*Other GROUT SPECIFICATIONS I ICtU Mt.t- <br /> COMMENTS: lw f -ftJJA1 S jW*,e I F L v t <br /> TYPE OF WELL INSTALLATION TYPE CONSTRUCTION SP FICATIONS <br /> 0 MONITORING 0 HOLLOW STEM DIA.OF BOREHOLE..Ib , MULTIPLE CASINGS []MULTI-LEVEL WELL CASING DIA: <br /> 0 EXTRACTION 0 AIR HAMMER/DRIVEN CASING THICKNESS TYPE OF CASING: 0 STEEL 0 PVC 0 OTHER: <br /> 0 VAPOR 0 MUD ROTARY DEPTH OF GROUT SEAL TREMIE TYPE TO BE USED: 0 AUGERS 0 HOSE <br /> 0 AIR SPARGE/OZONE1*LISH POINT(GP or CPT)GROUT SEAL PUMPED: 0 Yes 0 No (NOTE: MAXIMUM •FRE�ALL DEPTH IS 30') <br /> 0 SOIL BORING 0 HAND AUGER GROUT SPECIFICATIONS j'�IIL — 4— 6f*PA/ 1 <br /> a OTHER: 0 OTHER APPROX.BORING DEPTH 3U t 0 BOLTED TRAFFIC BOX or 0 STOVE PIPE <br /> CONDUCTOR CASING PROPOSED (if YES,list specifications in comment section) <br /> COMMENTS: <br /> NOTE: OFFSITE BORINGS REQUIRE ACCESS AGREEMENT OR ENCROACHMENT PERMITS. <br /> 48 WORKING HOURS NOTICE REQUIRED FOR INSPECTIONS. <br /> hereby certi I have repa d this application and that the work will be done in accordance with San Joaquin <br /> County Ordi n an egulations, and all applicable California ateLaw <br /> Signed x Title/Company //^L�1�& <br /> Print Name G t1 ^ Date ' z <br /> DEPARTMENT USE ONLY <br /> SITE MAP IN UNIT IV FILE,ADDRESS: (',A4(4cstd- <br /> WORK PLAN DATED:_T610 S' <br /> Application Accepted By Date Issued S/Z�j/b 5 Area <br /> Grout Inspection By .1 ^ Ar cv Date —4' Z� �S� Final Inspection By Date <br /> Destruction Inspection By Date <br /> COMMENTS/CONDITIONS: <br /> ACCOUNTING ONLY: AID# FAC# <br /> PE CODES FEE INFO AMOUNT REMITTED CHECK# REC'D BY DATE PERMIT/SERVICE REQUEST# INVOICE <br /> a�oSR# zy O <br /> C-57_ WC=WAIVER_ C-57 Letter of Authorization to sign permit_Encroachment doc_ <br /> EHD 29-02-001 <br /> 9/30/2002 <br />
The URL can be used to link to this page
Your browser does not support the video tag.