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SU0002469
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ELKHORN
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2600 - Land Use Program
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UP-88-33
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SU0002469
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Entry Properties
Last modified
5/11/2020 11:19:03 AM
Creation date
5/8/2020 10:11:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0002469
PE
2626
FACILITY_NAME
UP-88-33
STREET_NUMBER
1050
Direction
W
STREET_NAME
ELKHORN
STREET_TYPE
DR
City
STOCKTON
ENTERED_DATE
10/26/2001 12:00:00 AM
SITE_LOCATION
1050 W ELKHORN DR
QC Status
Approved
Scanner
SJGOV\gmartinez
Tags
EHD - Public
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f <br /> I <br /> L �^ -Ski ............. APPLICATION FOR SANITATION PERMIT Permit No. <br /> . ._ <br /> (Complete in Duplicate) <br /> is Permit Expires 1 Year From Date Issued <br /> - - _ Dote Issued <br /> Th <br /> Application 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 C unty r finance No. 549. <br /> /050 <br /> JOB ADDRESS AND LOCATI N...dva,-A, <br /> Owner's Name.. - Phone--- ------------ <br /> f. - ----- - --- <br /> -. -- <br /> Address-----_--- <br /> Contractor's Name_...._. .._._ ... ....___j.... -_ . ._.-.- <br /> - .. ..... - Phone. <br /> - <br /> Installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ <br /> Number of living units: Number of bedrooms _...-r Number of baths .a. Lot size <br /> : - --. ---- -- <br /> .11 <br /> Water Supply: Public system ❑ Community system ❑ Private <br /> �epth to Water Table oft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Cfoy ❑ Adobe 2-"Hardpan ❑ <br /> Previous Application Made: (If yes,date ) No New Construction: Yes U?"No ❑ FHA/VA: Yes ❑ No ®--- <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well-AV..W- Distance J-rom f ndation._l -. M <br /> No. of compartments_' �..--.--Sizey .__-._ .•..-_-Liquid depth .- 2` Capacity <br /> Disposal d: Distance from nearest well/".. Distance from n atio <br /> ,„ 9-,,�� . . ...yDistance to nearest lot line._��-�_ � <br /> Number of lines... .._ �. _ Length of eacFi Ii <br /> ti;9 / �-Width of trench 92.,..... _ v <br /> Type of filter mate rial1,,4r�616 Depth of filter material_ Vi'^ Total len th... `� r <br /> � <br /> C' <br /> Seepage Pit: Distance to nearest well - <br /> Q� .Distance fro fou dation -_./-.('> Distance to nearest lot line .- <br /> Number of pits .� Lining material._ ` Size: Diameter <br /> Depth %0 /�.' <br /> Cesspool: Distance from nearest well...... . . .....Distance from foundation Lining material. <br /> ❑ Size: Diameter <br /> .Depth__. _ . _ Liquid Capacity. _ _ gals. <br /> Privy: Distance from nearest well _ Distance from nearest building... <br /> Distance to nearest lot line <br /> Remodelingand/or repairing describe <br /> an / P 9 ( ) 4�l��Z/✓SIG/���� - - -��--��� <br /> - ' -- <br /> -------------- <br /> ---- <br /> C . <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, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> (Signed)._...... .......... �_ 4- <br /> �-V_ _ -- .. <br /> -- J -.._. .. Contractor) <br /> BY - - - v�1-. ---(Title)-- <br /> (Plot plan, showing size of lot, location of system in r ion to wells, buildings, etc., can be placed on reverse side). <br /> _ FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY ..��.•_.- --- �t�� _tra�. _ ------------- --- -- --------- ------ DATE_. <br /> REVIEWED BY- .. DATE <br /> BUILDING PERMIT ISSUED._ _- �- --� _ DATE. <br /> r � - -- ... <br /> Alter ions and or recommendations:...�� �... . <br /> _...���. - l -G------- }�� --- <br /> --- ----- ._ <br /> _ - <br /> _ .... ..... .. �c�u�- ... .... .max------ <br /> . <br /> FINAL INSPECTION BY:._, c..,, c �- -. <br /> ..... ...._ Date.. S <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E.Hazelton Ave. 300 West Oak Street 12j Sycamore Street 205 West 9th Street <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> F.P.Ca. <br />
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