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5783
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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TURNPIKE
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2028
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4200/4300 - Liquid Waste/Water Well Permits
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5783
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Entry Properties
Last modified
1/31/2019 9:10:44 AM
Creation date
12/2/2017 2:24:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
5783
STREET_NUMBER
2028
STREET_NAME
TURNPIKE
STREET_TYPE
RD
City
STOCKTON
SITE_LOCATION
2028 TURNPIKE RD
RECEIVED_DATE
11/26/1954
P_LOCATION
BENEVIDO CASITY
Supplemental fields
FilePath
\MIGRATIONS\T\TURNPIKE\2028\5783.PDF
QuestysFileName
5783
QuestysRecordID
1955651
QuestysRecordType
12
Tags
EHD - Public
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APPLICATION FOR SANITATION PERMIT Permit <br /> (Complete in Duplicate) <br /> t � Date <br /> Applic&ion 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 ND LOCATION....off-Q__ .� _____________________ _ <br /> -------- -------------- --- -- ---------- <br /> �` � r <br /> Owner's Name.---� �? -------------------------------------- Pfiohe----_- v�_1�- <br /> Address----------------------------------------- •------------------ -------- ...... <br /> Contractor's Name -mer ------------------------------- Phone <br /> Installation will serve: Residence ❑ Apartment HouseCommercial Trailer ❑ El O Court Motel her L]Number of living units: _"__ Number of bedrooms� L]_ Number of baths ...._._ Lot size -------1R. .._ �------------------------------- <br /> Water Supply: Public system Comrnunify system'❑ Private ❑ Depth to Water Table -------- ft. <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 ❑ New Construction: Yes Na ❑ ! <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: { <br /> (No septic tank`or cesspool permitted if public sewer is available within 200 feet.) <br /> e ti n"r Distance from nearest well----- ----------Distance from foundation_........-.- -,___.Material........___.-..._..---.-------------....._-._--. <br /> No. of compartments----- --------------- ---Size'--------------------------------Liquid depth.-------------------------Capacity-------------�----- <br /> Disposal Field: Distance from nearest well_�AC+S._'Distance from foundation__------------;..._.Distance to nearest lot line----�___-..... <br /> Number of lines...............l-.....11. eng h of each line------l.O=.C5-----------Width of trench.... ____ ..--_.--.___ <br /> Type of filter material )!-C_ d�f filter material---/._�- .......Total length--------fe--_d------------------- <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 /> y <br /> ❑r Size: Diameter-----.--=----------- ----_-- =Depth4 ------=--_-------------------- _ ' —Liquid-Capacity-.-=---------------------=__gals. , <br /> Privy: Distance from nearest well---------------------------------------------------Distance from nearest building-----`-----------------------------------. <br /> ❑ Distance to nearest lot line------------------------------------------------ = ---•-••--------------Z�_, <br /> ---------------------------- --------------------- <br /> Rem elfin a �or repairin (des �'�-4• .�j... <br /> ------------------------------------------------------------------------------------------------------ <br /> .--------------------------------- ----------- --- <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, 4stattlaws, and rules and regulations of the San Joaquin Local Health District. <br /> (Signed) �---------------------------------------------- A (Owner and/or Contractor) <br /> � 4 <br /> BY: .----•-------•-------- <br /> --------------------------------------------------------------------------(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 /> REVIEWEDBY ----------- ---------------------------------------------------------------------------•--• DATE <br /> BUILDING PERMIT ISSUED------------------------------------------------------ -------•----------------------------- --------- DATE <br /> Alterations and/or recommendations:--------- ----------------------------------------z-----------------------------..... ------------------------- --------------------- ------- <br /> ----------------------------------- ----------- ---------------------------- ------ ------- -------------------------------------------------------•-----•---------------------------•---- ---- ---------------.------ <br /> FINAL INSPECTION BY:----------- <br /> --------------------=--------------- Date----- -------- r ------ -------•------ <br /> SAN JOAQUIN LOCAL HEALTH`DISTRICT 1� <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 W-2100 <br />
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