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6335
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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JULIET
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2640
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4200/4300 - Liquid Waste/Water Well Permits
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6335
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Entry Properties
Last modified
2/2/2019 10:06:48 PM
Creation date
12/2/2017 6:43:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
6335
STREET_NUMBER
2640
STREET_NAME
JULIET
STREET_TYPE
RD
City
STOCKTON
SITE_LOCATION
2640 JULIET RD
RECEIVED_DATE
05/20/1955
P_LOCATION
G M WINCHELL
Supplemental fields
FilePath
\MIGRATIONS\J\JULIET\2640\6335.PDF
QuestysFileName
6335
QuestysRecordID
1801924
QuestysRecordType
12
Tags
EHD - Public
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� APPLICATION FOR SANITATION PERMIT Permit No. <br /> (Complete in Duplicate) , <br /> Date Issued ____V,-�-,f 5 <br /> Aglica*ion is hereby made to,the San Joaquin Local Health District for a permit fo construct and install the work herein described. <br /> This application is made in compliance with County Ordinance N 549. <br /> �( n <br /> JOB ADDRESS A LOCATION r ------------------------------------------ -------••-------------------------------------- <br /> iOwner's Name -- ------------ <br /> ----- -- .. Phone------------------------------------ <br /> Address-------— ------------- -- ---•-- ----s---•--.. <br /> .......-------- <br /> �/' <br /> Contractor's Name , '`' '' --- -� . - ----• •--•-- Phone---/-_Y'6- -- <br /> Installation will serve: Residence jo Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel I] Other [– <br /> Number of living units: _/----- Number of bedrooms _ _. Number of baths --ej_--_ Lot size ______f l� _.__ __ .. ---A______________________ <br /> Water Supply: Public system ❑ Community system ❑ Private a 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 [)5. New Construction: Yes Z, 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-------�I----____Distance from foundation-------/_�---------Materia,I!___e� -.--_---. <br /> © No. of compartments------,-`_...__�f__Size____..-= --X__ _Liqui� rh ------f 3. --------.-Capacity---- - -� -fes <br /> Disposal Field: Disfance from nearest well_...__.._._...Distance from foundation_____ ___ ______ Distance to nearest lot lin O_____-__ <br /> - /.j------- <br /> Number of lines-_______/._... Length of each line_________ ___ <br /> � - -- - -- g ��____.Width of trench.___�_�' <br /> Type of filter Material--- Depth of filter material-------)_� .....Total length________ _____________________ <br /> Seepage Pit: Distance to nearest well_-__—At1------Distance from our�dation______ -6r----Distance to nearest lot line_.__lG_f---- <br /> Number of its:_-______ Linin material___- _0� ze: Diameter ___De t'n____.�a --- <br /> 1�1 p � 9 - p <br /> Cesspool: Distance from nearest well________.._____Distance from foundation___-----------------Lining material_____.___________-_-______.___-__--- <br /> ❑ Size: Diameter------------------------- - -------Depth...-------------------------------------------------Liquid Capacity----------------------------gals. <br /> Privy: Distance from nearest well............._--------------------------- .......Distance from nearest building-----___---__.___________._____--_-:-_.- <br /> ❑ Distance to nearest lot line-------- --------- - - ----- -- -------=--------•----------------------=------------------------------------------------------ -------------- <br /> Remodeling and/or repairing (describe)------------------------------------------------------------------------------------------------------------------------------------------ -----• . <br /> ----------------------------------------------------------------•----------------------------------•-----•-----------------------------------..--------------------------------------=-v <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, Stat aw , and rules and regulations of the San Joaquin Local Health District. <br /> ----------------------------------------- ---(Ow er and/or Contractor) <br /> (Signed) ------ <br /> Bri--------- - �� --------------------------(Tale)-------- -:5 - ------------------------------------- <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- =---- ----------------------------------------f,r - --- ------------------------------ DATE----------------- <br /> REVIEWEDBY--------------------------------------------- --------- -------------------------- ------------------------------------------ DATE------------------------ <br /> BUILDING PERMIT ISSUED------------------------- ----------- -------------------•-•----------------------------------••---- DATE-----_------------- <br /> Alterations and/or recommendations:----------------------- . ----- - - -- - ----.-...-•------------------------------------------------------------------------------ ------ <br /> I _________________________________________________________ __�_._. R <br /> ____________________________________________________________ /jJ,'�/� / /J)�/f �..-� j <br /> R <br /> ----------------------------------------------------------------------------------------- <br /> ---- ------------------------•____...._____ .__•_____.___-_-_..--- ..__•__-.___ __. __._._ ____-_____ ' <br /> FINAL INSPECTION BY:---------- - -F� - - Date------_-------- i <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street 132 Sycamore Street 1�,,'" _ 814 North "C" Street. <br /> Stockton, California Lodi, California Manteca, California ] Tracy, California <br /> E5-9-2M 145446 ATWOO❑ 12.54 <br />
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