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20301
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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20301
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Entry Properties
Last modified
12/30/2018 10:06:31 PM
Creation date
12/2/2017 6:43:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
20301
STREET_NUMBER
2955
STREET_NAME
JULIET
STREET_TYPE
RD
City
STOCKTON
SITE_LOCATION
2955 JULIET RD
RECEIVED_DATE
03/18/1966
P_LOCATION
MR WALTER WELCH
Supplemental fields
FilePath
\MIGRATIONS\J\JULIET\2955\20301.PDF
QuestysFileName
20301
QuestysRecordID
1801966
QuestysRecordType
12
Tags
EHD - Public
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FOR OFFICE USE <br /> ------- <br /> 3'r - <br /> APPLICATION FOR SANITATION PERMIT Permit No. c .03 <br />--------------------------- <br /> ----------- (Complete in Duplicate) Date Issued <br /> - <br /> ------ ---------------- ----------- <br /> This Permit Expires I Year From Date Issued <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 County Ordinance No. 549. <br /> 1 ------------ <br /> Owner's <br /> 7-- <br /> JOB ADDRESS AND LOCATION----- _ S 5�--------Sc- _, _1.-_ `__-----..! --`--------------- _ <br /> 2_t _C_ ------------------------- Phone__( _a=--- <br /> Owner s Name------NI--4-•------��-�9'--��_��--�' --------.�,.�� _ ---------------- ----- ---- <br /> Address .-------•-- °S '- --•---� K .�i..N-_E-�.------------------------ '---------------------------------•--------- •--------. - <br /> Contractor's Name ------------- -------------S-.c---------C-v-- --------- --------------•--- Phone------ -----•- --- <br /> Installation will serve- Residence a Apartment House ❑ Commercial El Trailer Court ❑ Motel ❑ Other El I <br /> Number of living units: __,____ Number of bedrooms ___ Number of baths ---I--- Lot size _____ _C3------- <br /> Water <br /> : 3------ <br /> Water Supply: Public system ❑ Community system ❑ Private Depth to Water Table .50- ft. <br /> Character of sail to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ AdobeZ Hardpan ❑ <br /> Previous Application Made- (If yes,date--------------------) Nox New Construction. Yes ❑ No FHA/VA: Yes ❑ NoX <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool pefm'it#ed if public sewer is available within 200 feet.) <br /> _ -Material__..____-----.------ <br /> Septic Tank:''f Distace from nearest well_____!..:---_—,_Distance romounavn_---------- ----- <br /> NC ---------------------Ca Capacity----------------------- <br /> El <br /> ---------------------- <br /> ❑ sNo. of compartments------------- ------- - Size : qu.d <br /> Disposal Field: Distance from nearest well..._,5 C_.-_._Distance from foundation-------d.r .......Distance to nearest lot line__-__:----------- <br /> y e,*15'FIrl() Number of lines-1---------------j----------------Length of each line-----------7._0 -------Width of trench--- -- - -.-- . <br /> �flD Type of filter material� - __ = '9.1C-__Depth of filter material-------- --_- ---Total length------ ------------------C ��-- <br /> ! ' <br /> Seepage Pit: Distance to nearest well_-..)_rC�,_--._._Distance from foundation------1.P.-•__--Distanceto nearest ]Of line---- -___._ <br /> Number of Pits---,------T- <br /> -•------Lining material__'•--2r> aSSize: Diameter.-------= - ------ <br /> -Depth------------2.67!---------- A^ <br /> Cesspool: Distance from nearest well-__-__--____--_-Distance from foundation____._____-.__-...Lining material__.. <br /> ❑ t Size: Diameter - -----.Depth-------- -------• I------------ -------------------Liquid Capa ditY-- .--+- ;y------�---gals. r , <br /> S I _- -�`'_..__'-_Distance from nearest buildin <br /> Privy: Distance from nearest well--------------------- _ building] -------------- <br /> Privy: <br /> ----- f---------- , <br /> __ A---, ----- �� --- ---------- ----------- <br /> ❑0 <br /> Distance to nearest"lot line-- -- <br /> at.a'�1 t ` ----------- <br /> CP� — <br /> Remodeling and/or repairing (describe)--- ----- - --- --------------- --- �K-�-�•-----�-t�-�-----------=.��'�__L�.--�'"�--------------- <br /> I ! ------ ------------------------------------- <br /> ----------------------- --- ------------------------------- ------------------- . , <br /> <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 /> --- --- -------_(Owner and/or Contracforl <br /> -------------------(Signed). (Title)--- <br /> By: <br /> ------- <br /> � - {Title)_- <br /> Br------------------- <br /> (Plot plan, showing size of lot, location:of system in r ation to wells, buildings, etc.,,can be,placed on reverse side). <br /> r! <br /> k FOR-DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY-------------a- -- --------- <br /> DATE-------- ------------------------- -------------------- <br /> -- - DATE-------- ---- <br /> - --------- - - - <br /> REVIEWEDBY----------------------------------- ---- - -- ---------------- <br /> G BUILDING PERMIT ISSUED-------•-----1----------- -- - <br /> - -- --- ---------------------- - DATE-------------------------------------------------- ---------- <br /> s -;Tze == <br /> Alterations and/or recommendations:-.._--. <br /> t ----------- ---------------------- <br /> ... _ ------------------------------------ <br /> ,4-- --------------------------`----------------- <br /> --------------------- <br /> F I <br /> ----------------------- <br /> ----------------- ------- ----------- ------------------------------- <br /> aa---------- <br /> .. .. Date:_. ---4-------- -- -..................- ------<----- ------- <br /> I <br /> F1NAL".:-INSPECTION"BY E.-,..� s-b- -- <br /> SAN JOAQUIN LOCAL;HEALTH DISTRICT` <br /> f 1601 E.Hazelton Ave. 300 west Oak Street 124 sycamore Street 205 West 91h Street <br /> Stockton,CaliforniaLodi,California Manteca,California Tracy,California <br /> F.p.c a. <br /> I __ <br />
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