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SR0082715
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082715
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Entry Properties
Last modified
3/2/2021 2:08:49 PM
Creation date
3/2/2021 2:02:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082715
PE
4222
STREET_NUMBER
16510
Direction
N
STREET_NAME
LOCUST TREE
STREET_TYPE
RD
City
LODI
Zip
95240
APN
05112042 & 94
ENTERED_DATE
10/9/2020 12:00:00 AM
SITE_LOCATION
16510 N LOCUST TREE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Tags
EHD - Public
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Site Address: 16510 North Locust Tree Road, Lodi Record ID: SR0082715 <br /> Date: 12/01/2020 <br /> PHOTO#1 Comments: Percolation test form <br /> ,0^4`'Iti SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> ` 1868 East Hazelton Avenue,Stockton,CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: ( �nqUN WLJS� TVu 1� —CITY: <br /> OWNER NAME•_\�C' \�a"aC( DATE: 17-- 1 - Zo <br /> APN:—L,sl- 1"2.0- �-}2+ 9y APPLICATION#: DEPTH TO FIRST WATER: Ft ' <br /> SOIL TYPE: SG^d 1 tae <br /> REMARKS: <br /> LOCATION OF TEST HOLES sHow WELLS AND STRUCTURES <br /> I I ! I <br /> I : <br /> t a i l I I I t <br /> 1 — -- - <br /> SOIL PROFI E IF REQUIRED <br /> De th Soil T e Depth Soil T e De th Soil T e De th Soil T De th Soil T e <br /> Test Hole#2 <br /> Test Hole#1 parcel: Diameter: in De the in4 " <br /> in De the 2 in <br /> Parcel: Diameter: <br /> TIME READING WATER DROP REFILLED <br /> _ TIME READING WATER DROP REFILLED Y o 1 - ,2•�[S <br /> ..0- 3.0S : 3/ <br /> 06..30 3 •L"t 6•Z2 ,o/ 3 is <br /> ;ue .ye 6.13 –_ 31 0 o•t Z•To <br /> 30 .5-4c'•102.Qa o'ZO <br /> U;oo 3. -8 O•o v:3 0.15_ <br /> 3-toy 6 .0-1 3.t t 0. <br /> — <br /> 1 _0l <br /> ;ao ,to n•ts II_3 3•I11 o•O <br /> 30 0,10 S .o9 <br /> 3,20 <br /> I to <br /> 0 L <br /> 00. j. z1 .0 9 — <br /> 1 minlin <br /> ZT•1 — <br /> min/in PERCOLATION RATE: k <br /> PERCOLATION RATE' RECOMMENDED SEPTIC AREA: <br /> Date �-- <br /> RECOMMENDED SEPTIC <br /> AREA: <br /> ` phone: Date ` <br /> Phone: <br /> TEST PERFORMED BY: pale <br /> TEST CERTIFIED BY: Phone PER,TEST RATE FORM <br /> OBSERVED BY(RENS):Elio 42-03 42-03 REV 11 r2fflg <br /> -, <br /> Aaron Gooderham, Environmental Health Specialist Page 1 of 1 <br />
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