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SR0081396
EnvironmentalHealth
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LEMON
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4200/4300 - Liquid Waste/Water Well Permits
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SR0081396
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Entry Properties
Last modified
1/23/2020 8:48:55 AM
Creation date
1/23/2020 8:22:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0081396
PE
4222
STREET_NUMBER
28484
Direction
E
STREET_NAME
LEMON
STREET_TYPE
AVE
City
ESCALON
Zip
95320
APN
24911023
ENTERED_DATE
11/13/2019 12:00:00 AM
SITE_LOCATION
28484 E LEMON AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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O r* (D <br /> D O Q <br /> N <br /> #plA,'A SAN JOAQUIN COUNTY N N <br /> 7' ENVIRONMENTAL.HEALTH DEPARTMENT <br /> 'I 1868 East Hazelton M N N <br /> Avenue,Stockton.CA 95205.6232 <br /> Telephone(:001468.3420 Fe),(200(464 0138 Web:www s n F� � <br /> lRlTbw¢ jgov Drg/elld O_ LD 00 <br /> M PERCOLATION TEST RATE 00 <br /> � ff A <br /> ADDRESSOR LOCAT _ J4 t l (' �,y T�. ( 1 p F- <br /> O OWNER NAME._ __ --- - <br /> APN: �L1L J-+ '_APPLICATIONM u`i�0 I�[111, _-DATE.__.IL.1�1 I q O <br /> (D SOIL TYPE - ,_,�_ 1' �`�--- DEPTH TO FIRST=WATTE_RI_-1-�• F1 ( =3 <br /> REMARKS \Y \ I\- + I ----- <br /> 1�- <br /> -E.f' . IG'•u�l rD <br /> _ '1._ Ml_L M m <br /> r0 LOCATION OF TELn <br /> ST HOLES SHOW WELLS AND STRUCTURES C <br /> -r1 [1 i [1 1r-i nr([.k I r p i 1 r i_1 <br /> T-- <br /> 6T- <br /> SOIL <br /> SOIL PROFILE IF REQUIRED <br /> Y'+ De th <br /> SOL'T e De,1h Soil T e De th Soil Type De th Soil Type Depth Soil T <br /> ype• <br /> _ Test Hole#1 Test Hole#2 +e[ <br /> Parcel: Dthe iameter: in De i in Parcel: the __Diameter: in De in <br /> w • <br /> w (` % '•`w <br /> ,'A•P�,. TIME -R ING WATER DROP (y REFILLE TIME READING_ WATERDROP REFILLED <br /> hC M111 <br /> ':�� LIS I :,. • T`,( <br /> CLh� <br /> s TYf•• 14,K?M I L1,3� I_. h,0 U _ 3► ---- - '-- — r,�' „, <br /> f <br /> PERCOLATION RATE: minlin PERCOLATION RATE: minlin <br /> RECOMMENDED SEPTICAREA: RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: 1 �'`l Phone:��`��U �J+04 Date <br /> TEST CERTIFIED BY: Phone: Date ( �,�•"` <br /> OBSERVED BY(REHSI' P* `� Phone <br /> I <br /> Date <br /> ' <br /> EHD 42-03 REV 1717105 PERC TEST RATE FORM , <br /> 0"w ID <br /> ov <br /> CL <br /> aq <br /> r <br /> y� v<. ' •.'. .may',�f� �;; LC) <br />
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