My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SU0006328 SSNL
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
E
>
ESCALON BELLOTA
>
4391
>
2600 - Land Use Program
>
PA-0600516
>
SU0006328 SSNL
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
5/7/2020 11:32:19 AM
Creation date
9/4/2019 6:09:41 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0006328
PE
2687
FACILITY_NAME
PA-0600516
STREET_NUMBER
4391
Direction
S
STREET_NAME
ESCALON BELLOTA
STREET_TYPE
RD
City
FARMINGTON
APN
18713010
ENTERED_DATE
11/20/2006 12:00:00 AM
SITE_LOCATION
4391 S ESCALON BELLOTA RD
RECEIVED_DATE
11/20/2006 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\E\ESCALON BELLOTA\4391\PA-0600516\SU0006328\SS STDY.PDF \MIGRATIONS\E\ESCALON BELLOTA\4391\PA-0600516\SU0006328\NL STDY.PDF
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
56
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
r. APPLICATION FOR WELLIPUMP PERMIT <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P 0 BOX 388, 446 N. SAN JOAQUIN ST., STOCKTON,CA 96201.388 <br /> (209) 468.3420 <br /> dyO �PIIRIMIT i TEAR FROIl9 GATE ISSUED <br /> ripfieatel <br /> APPLICATION IS HERE BY MADE TO THE SAN JOAQUIN COUFOR PD/OR INSTALL THE WORK DESCRIBED,THIS APPLICATION IS MADE IN COMPLIANCE WITH SAN <br /> JOAQUIN COUNTY DEVELOPMENT TR-LE.CHAPTER 8-1115.3 A��NryID THE STANDARDS OF SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES,ENVIRONMENTAL HEALTH DIVISION, <br /> � <br /> JOB ADDRESSOR APN# - �' CITY_� ,yL, r UI S V,- PARCEL SIZVAPNIf <br /> 4 OWNER'S NAME tv-;. V 12 t t 1 ADDRESS s <br /> f —� t .�� � d — <br /> PHO�N E i <br /> �I <br /> CONTRACTOR , L... ,.ADDRESS -S 0•�LICi.*?. Y�/ PfIONE i—Vd5r�j1 y <br />`r SUB CONTRACTOR ADDRESS LIC# PHONE/ <br /> R TYPE OF WELUPUMP: ❑ NEN!WELL ❑ REPLACEMENT WELL ❑ MONITORING WELL# ❑OTHER <br /> ❑ INSTALLATION ❑WELL SYSTEM REPAIR ❑ CROSS-CONNECT REPAIR ❑ VAPOR EXTRACTION WELL# ✓ <br /> I L' ' .❑Naw Repelr H.P. fzQ _ DEPTH PUMP SE t2QFT. FIRST WATER LEVEL_ - <br /> I (TYPE OF PUMP) "..— O <br /> [3 OUT-OF-SERVICE WELL 13 GEOPHYSICAL WELL i ❑ SOIL BORING g <br /> ❑DESTRUCTION: <br /> I INTENDED v1:E TYPE OF WELL CONSTRUCTION SPECETICATIONS A <br /> I ❑ INDUSTRIAL ❑OPEN BOTTOM DIA.OF WELL EXCAVATION DIA.OF CONDUCTOR CASING D <br /> ❑ DOMESTICIPWVATE 13 GRAVEL PACK/SIZE TYPE OF CASINOISTEELIPVCDIA.Of WELL CASING i' p- <br /> ❑ PUBLICIMUNtCIPAL ❑DRIVEN DEPTH OF GROUT SEAL - <br /> {gyp sPECIFtcaTwN ,x <br /> q IRRIGATtON/AG ❑OTHER GROUT SEAL INSTALLED BY GROUT BRAND NAME ---� E <br /> ❑ MONITORING - ' 'r GROUT SEAL PUMPED: 13Y. 13 Ne CONCRETE PEDESTAL BY DRILLER:❑Yee ❑No S <br /> per'' <br /> APPROX.DEPTH_ _ 2 J b LOCKING CHESTER BOXISTOVE PIPE S <br /> r PROPOSED CONSTRUCT10N10WLUNO METHOD: MUD ROTARY AIR'ROTARY AUGER CABLE OTHER 11 <br /> I I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THAT THE WOW WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES,STATE LAWS,AND RULES AND <br /> t REGULATIONS OF THE SAN JOAQUIN COUNTY. HOME OWNER OR LICENSED AGENT'S SIGNATURE CERTIFIES THE FOLLOWING:'I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH <br /> THIS PERMIT IS ISSUED,I SHALL NOT EMPLOY PERSONS SUBJECT TO WORKMAN'S COMPENSATION LAWS OF CALIFORNIA.- CONTRACTOR'S HIRING OR SUBCONTRACTING SIGNATURE CEFMfIES <br /> THE FOLLOWING: .I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,1 SHALL EMPLOY PERSONS SUBJECT TO WORIOAAN•S COM T10N LAWS OF <br /> _ CALIFORNIA.' CANT MUST C .24 ND N ADVANCE FOR ALL REOMED INSPECTIONS AT 12001468-3422. COMPLETE DRAWING AT LOWER AREA PROVIDED. <br /> _ Slumd X Title aV 5Dete <br />} PLAT PLAN IDrew to Seelel Sole "m <br /> 1 1. NAMES OF STREETS OR ROADS NEAREST TO OR BOUNDING THE PROPERTY, 4. LOCATION OF HOUSE SEWAGE DISPOSAL SYSTEM OR PROPOSED <br />_ 2. OUTLINE OF THE PROPERTY,GIVING DIMENSIONS AND NORTH tNRECTMN. EXPANSION Of SEWAGE DISPOSAL SYSTEMS. <br /> 3. DIMENSIONED OUTLINES AND LOCATION OF ALL EXISTING AND PROPOSED S. LOCATION OF WELLS WITHIN RADIUS OF ONE HUNDRED FIFTY FT. <br /> _ STRUCTURES INCLUOING COVERED AREAS SUCH AS PATIOS,DRIVEWAYS AND WALKS ON THE PROPERTY OR ADJOINING PROPERTY. <br />' - <br /> DECA-5 -1995 <br /> ............ <br /> HEA <br /> Ll <br /> Irk <br /> . ..... <br /> 4 . <br /> . ... <br /> A, <br /> 4 <br /> ............................. ...................... <br /> ...... ............ ....... <br /> ...... ................ <br /> ............ <br /> . .. . <br /> ...... ..... �.. `� ................ <br /> . ........... <br />
The URL can be used to link to this page
Your browser does not support the video tag.