My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
89-22
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
T
>
TRETHEWAY
>
19500
>
4200/4300 - Liquid Waste/Water Well Permits
>
89-22
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
12/28/2019 10:04:45 PM
Creation date
12/2/2017 1:52:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
89-22
STREET_NUMBER
19500
Direction
N
STREET_NAME
TRETHEWAY
STREET_TYPE
RD
City
LODI
APN
01724019
SITE_LOCATION
19500 N TRETHEWAY RD
RECEIVED_DATE
12/28/1988
P_LOCATION
CRANSTON VINEYARDS
Supplemental fields
FilePath
\MIGRATIONS\T\TRETHEWAY\19500\89-22.PDF
QuestysFileName
89-22
QuestysRecordID
1951424
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
APPLICATION FOR PERMIT <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> JNA 1601 E. HAZEL T ON AVE., STOCKTON, CA-� <br /> Telephone (209) 466-6781 <br /> PERMIT EXPIRES 1 YEAR FROM DATE ISRUED <br /> (Complete in Triplicate) DEC r/z 19$8 <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and/or install the work herein described. This application is <br /> made in compliance with San Joaquin County Ordinance No.549 for sewage or No. 1862 for well/pumpEnq,the-Rules-and-.Regulations of the San Joaquin <br /> Local Health District. � �a 7�0._C1-7-re-iw �p ro"..' i aE:?V'c— <br /> i lf � <br /> Job Address A! tc c cit _ Lot Size <br /> f_ R n i-K- <br /> Owner's Name / Address 0 J=/ &.4,k_- 09dm mP.Z Phone <br /> w � QQ <br /> Contractor f dress License No..2774_1 __ _Phone <br /> TYPE OF WELL/PUMP: NEW WELL WELL REPLACEM T ❑ DESTRUCTION ❑ <br /> PUMP INSTALLATIPN ❑ SYSTEA REPAIR ❑ O ER ❑ <br /> DISTANCE TO NEAREST: SEPTIC TANKSEWER LINE$ bISPOSAL FLD. PROP. LINE <br /> FOUNDATION AGRICULTURE WELL OTHER WELL PITS/SUMPS <br /> INTENDED USE TYPE OF WELL PROBLEM AREA CONSTRUCTION SPECIFICAT_ONS <br /> Al Q <br /> ❑ Industrial pen Bottom 11 Manteca ' 'bia. of Well Excavation Dia. of Well Casing <br /> ",--_estic/Private ❑ Gravel Pack ❑ Tracy Type of Casing or Specifications <br /> I'1 Pirbli H Other F.1 Delta Depth of Grout Seat .. Type of Grout <br /> I rrigatPon 4-&D--Approx. De th l I Eastern Surface Seal Installed by <br /> Repair Work Done ❑ Type of Pump H.P. 2 State Work Done <br /> Well Destruction ❑ Well Diameter Sealing Material (top 50') <br /> Depth Filler Material (Below 50'1 <br /> TYPE OF SEPTIC WORK: NEW IN91ALLATION71 REPAIR/ADDITION f I DESTRUCTION I 1 (No septic system permitted if public sewer is <br /> available within 200 feet.) <br /> Installation will serve: Residence_ Commercial____ Other <br /> Number of living units: Number of bedrooms <br /> Character of soil to a depth of 3 feet: Water table depth <br /> SEPTIC TANK ❑ Type/Mfg Capacity No. Compartments <br /> PKG. TREATMENT PLT. ❑ Method of Disposal <br /> Distance to nearest: Well Foundation Property Line ; <br /> LEACHING LINE t ❑ No. & Length of lines Total length/size U <br /> FILTER BED i ❑ Distance to nearest: Well Foundation Property Line d <br /> r <br /> SEEPAGE PITS # I I Depth Size Number <br /> SUMPS ❑ Distance to nearest: Well Foundation Property Line , <br /> DISPOSAL PONDS ❑ <br /> I hereby certify that I have prepared this application and that the-work will be done in accordance with San Joaquin county ordinances, state laws, aml� <br /> rules and regulations of the San Joaquin Local Health District. .z <br /> Home owner or licensed agent's signature certifies the following: "I certify that in the performance of the work for which this permit is issued, I shall not <br /> employ any person in such manner as to became subject to workman's compensation laws of California."Contractor's hiring or sub-contracting signature <br /> certifies the followinb: "I certify that in the performance of the work for which this permit is issued, I shall employ persons subject to workman's compensa- <br /> tion laws of California." <br /> The applicant st call 0 01 <br /> for a1 <br /> Signed Title: Date:ired inspections. Complete drawing on ers�esiysirrde. <br /> �l fes- rip �► <br /> FOR DEPARTMENT USE ONLY l �n <br /> Application Accepted by Date (� Area `'(� <br /> Pit or Grout Inspection by IM4 Date__J- Final Inspection by_ 1 Date.Z--? <br /> Additional Comments: <br /> ❑ Stk 466-6781 ❑ Lodi 369-3621 ❑ Manteca 823-7104 ❑ Tracy 835-6385 <br /> Applicant- Return all copies to: Environmental Health Permit/Services 1601 E. Hazelton Ave., P.O. Box 20W, Stk., CA 95201 <br /> FEE <br /> INFO AMOUNT DUE AMOUNT REMITTED CASH CK f RECEIVED BY DATE p�PPEE-R�yMIT'NO. <br /> +.EH <br /> EH 114-26-24 1 pEV.r i H 51 1 10s, <br /> 1 <br />
The URL can be used to link to this page
Your browser does not support the video tag.