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68-122
EnvironmentalHealth
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LONE TREE
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4200/4300 - Liquid Waste/Water Well Permits
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68-122
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Entry Properties
Last modified
2/5/2019 10:21:35 PM
Creation date
12/2/2017 10:25:08 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
68-122
STREET_NUMBER
18514
Direction
E
STREET_NAME
LONE TREE
STREET_TYPE
RD
City
ESCALON
SITE_LOCATION
18514 E LONE TREE RD
RECEIVED_DATE
02/07/1968
P_LOCATION
JOHN DUNCAN
Supplemental fields
FilePath
\MIGRATIONS\L\LONE TREE\18514\68-122.PDF
QuestysFileName
68-122
QuestysRecordID
1826907
QuestysRecordType
12
Tags
EHD - Public
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FOR OFFICE USE: <br /> k <br /> C APPLICATION FORs°SANITATION PERMIT Permit No. :...1. ? <br /> ------- -- --- -- ----------- ------------- ---- . _ <br /> --------------------- ---------------------- --------- (Complete-in Duplicate) i. <br /> ......................__.._.__..._-- This Permit Expires 1 Year From Date Issued <br /> '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 /> JOB ADDRESS AND LOCATION ' ��� =!•-- <br /> ----------------------------------- <br /> Owner's Name--- Phone <br /> --- ------ ' <br /> f Address--------------- t <br /> - --�-- -------'-------•------ <br /> Contractor's Name------ ���� .._.'-' 1 Phone `l <br /> Installation will serve: Residence . Apar4ment Nouse [] ~Commercials❑ Trailer Court ❑ Motel ❑. Other ❑ <br /> Number of living units: _j-----f Number of bedrooms, 7z___ Number of baths-A-- Lot size _____ ___ _________________ ________________________________ <br /> Water Supply: Public system ❑ tommunity system ❑ Private JU Depth to Water Table ______ _ ft <br /> Character of soil to a depth of 3 feet Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam W Clay ❑ Adobe❑ Hardpan ❑ <br /> Previous Application Made: (If yes,date_- ------- } No ❑ New Construction: Yes ❑ No ❑ FHA/VA: Yes ❑ No ❑ <br /> A <br /> .:TYPE�OF=.INSTALLATION_,AND SPECIFICATIO.NS:_,,,;.:' <br /> -� - ; <br /> (No septic tank or cesspool permitted if public'-sewer is available within 200 feet.) <br />" F r <br /> Septic Tank: Distance from nearest weil_1g0/Distance from foundation---�a. -_ <br /> --- Material.-------- -"-'------------'----' - ---�--� <br /> Li uid a th- -A_,6"i('1 Capacity <br /> ® No, of compartments------.--ar�--------------Size-- - -•--'----•---- G P. A Y--- <br /> r - � <br /> Disposal Field: Distance from nearest well-YAAWDistance from foundation- D Distance to nearest lot line-.-._-_--______- <br /> I <br /> Ell Number of lines! ------------------Length of each line__ _____6 -----------------Width of trench-.-v°- . ___ _______. <br /> I Type:of filter material._- /_ ._.______-Depth of filter material.__. .Q� rrg 'Total len th-... f �___ ' <br /> C � --------- <br /> Seepage Pit: Distance to nearest welL___�.J'� istance from foundation__R0 ___ Distance to nearest lot <br /> ® z r iline-_._-._._-___.._ <br /> Number ofPits__1 ..�'--'-- -__Lining material__-.._ -_-._.--- -' - Size: Diameter. ��k-i1�h ;I �epth_.--f-��- <br /> ` <br /> j. .____-__ <br /> Cesspool: Distance from nearest well ________________Distance from foundation....___._.___ . _.Lining'matenaf-.--_--_-____._-.._.__-_._____-______, <br />' ❑ Size:.Mameter- -- --------- --'-- ----- ------- --DePth- --- ------------ ---------- ' ' ----- ------ Liquid Capacity-------------------`---------gals. <br /> Privy: Distance from e'arest.well--------------------------_------_---___---------Distance from nearest building----t-__.----------.----------. . <br /> ❑ Distance to nearest lot line ---------------------------------------- ------------------------------------------------------ ---------- --' .................... <br /> + <br /> Remodeling and/or repairing (describe): y. T-----------.". -----, "..M -------- <br /> ------------------•-------------------------------------- --•------------•---- ------- ----:------------ --'- i----- -----------=- <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 /> r ordinances, State laws, and-rules and-regulation's-af thd"San Joaquirs-L6�al-cal _. <br /> k <br /> (Signed) �f y C� � ?? _ -- -- ------------------ --- �. -'-'-'-'- ............(Owner and/or Con+rector) <br /> - .� <br /> BY ------------------------------------------------- - - -------------- (Tifile')._ _.. - '- -� `- -- ..... <br /> (Plot plan, showing size of lot, location of system in relation to wells, buil fags etc., can be placed on reverse side). 1 <br /> FOR DEPARTMENT,6SE ONLY <br /> APPLICATION ACCEPTED BY !. ---------------------------/------------------------------------- DATE ----- <br /> REVIEWED BY------------------------------------1-- DATE-------- <br /> ' --- �--'-'- ------'-'--------------'-' ------- ---------------'------------ -- '- -----------•---------'-------------'--------- ---- <br /> BUILDING PERMIT ISSUED-------------- --------------•--------------------------------------- DATE--------- ----- <br /> Alterations <br /> --- <br /> Ale - o - - -.or recommendations...-'-'-'-'-'- ---- --------------------------------------------_------------- ------------------------------------------- <br /> Alterations and/ <br /> - kl/ ��l-lht�r------ �y0------F-X1StTl-f1[_6------41917 '11�t_ ....0F -I SP <br /> Int�3 .-- hlS .__._ V� �. A cid' x_.u_ 5 -----N- - .__.._.0 K- <br /> ------ -- <br /> 7n-(0' <br /> TQ11� P -_- - --------------------------------------------------- -------------- ---------------------------------- <br /> FINAL INSPECTIONBY Date. ' ' <br /> a <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E,Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 91h Street <br /> Stockton,California Lodi. California �,_ tonteca,California Tracy,California , <br /> E.H.9 2M 1-67 Vanguard Press. <br />
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