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5380
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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4200/4300 - Liquid Waste/Water Well Permits
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5380
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Entry Properties
Last modified
1/27/2019 11:43:21 PM
Creation date
12/3/2017 1:29:40 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
5380
STREET_NUMBER
5324
Direction
E
STREET_NAME
MARSH
City
STOCKTON
SITE_LOCATION
5324 E MARSH
RECEIVED_DATE
07/13/1954
P_LOCATION
HENRY ROSS
Supplemental fields
FilePath
\MIGRATIONS\M\MARSH\5324\5380.PDF
QuestysFileName
5380
QuestysRecordID
1846022
QuestysRecordType
12
Tags
EHD - Public
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• a <br /> wtl APPLICATION FOR SANITATION PERMIT <br /> Permit No. _.aJ - "--.... <br /> a.. Date Issued <br /> (Complete in Duplicate) <br /> 7�"J----="---- <br /> Application is hereby made to the San Joaquin Local Health District fora permit to construct and install the work herein described. <br /> This application is made in compliance with County r inance No. 549. <br /> JOB ADDRESS AlLOCA ION"�� - <br /> ------------------------------------------ <br /> Owner's Name"-- ------••--- " <br /> = ----------- - --- Phone <br /> Address -----••--------------------------------- -- ----------------------------•----••---••--•- <br /> :: ---- § <br /> Contractor's Name------ ------ - - - ---- --- <br /> ---------- --------------------- <br /> Installation will serve:- Residence ❑ Apartment House ❑ Commercial ❑ Trailer -Motel ❑ Other El <br /> Number of living units: __.�____ `umber of bedrooms ----1- Number of baths ._�.... Lot size __"". ."""."-_--"___--""___--___"__"__-__".""._"_______..".- <br /> Water Supply: Public system Community system ❑ Private ❑ Depth to Water Table -------- ft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ❑ Hardpan ❑ t <br /> Previous Application Made: Yes ❑ No ❑ New Construction: 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-----------------Distance from foundation--------------------Material_._____________________________________ -------- <br /> I <br /> No. of compartments------- --------------Size--------------------------------Liquid depth--- ---------------Capacity---------- ------------ <br /> pisposal Field: Distance from nearest well_:__-__"__--__.--.Distance from foundation_-____"-____-___"._Distance to nearest lot line_____.__._____. <br /> l Number of lines__. --------Length of each line---------- Width of +Tench. <br /> ' Type of filter mfaterial------------- p Total length---.______._____•-----• ------- <br /> __.___._____Depth of filter matenaL_____________________ <br /> Seepage Pit: Distance to nearest well_.__...__--___._-__-Distance from foundation--------------------Distance to nearest lot ;ine----------------- <br /> Number of pits---------------------Lining material-----------------------Size: Diameter---------- - - - Depth--------------------------------- m <br /> Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material""".___---"_--___.__.___-_-.__._-.-__ <br /> Size: Diameter--------------------- --------------Depth---------------•------------------ ----------------Liquid Capacity---------------------------•gals. <br /> Privy: Distance from nearest weil-----..."---------------------------- Distance from nearest building----------------------------------------- .� <br /> ❑ --------- <br /> -------------------------------------------.---- <br /> Distance to nearest lot ine________.._.____________________________________ <br /> ` -•------•-- ----- --------------- ----- --- -�--- <br /> Remo elinpl� <br /> d/or rep a'in descr!i�e):_________ <br /> ------ - - - - <br /> --- ------------ <br /> - - L' - ----_______ __ S - <br /> �. --- -------- -- `--- - ----- -------------------------------------------------------------------------- <br /> Ihereby certify that I h v preparedis application and�that the work will be done in accordance with San Joaquin County <br /> ordinances, Stat laws, and rules and regulations of the San Joaquin Local Health District. <br /> (Signed)" _ <br /> •----- ------------------------------------------(Owner and/or Contractor) <br /> ! I Title <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 /> ' --------------- ------- DATE-----------•-- --�---------�----- - <br /> ---------------- <br /> APPLICATION ACCEPTED BY '?-. <br /> DATE--- ------------------------------------------------- <br /> REVIEWEDBY----------------------------- --- -- ----------------------------------------------------------- <br /> BUILDING PERMIT ISSUED----------------------------------- <br /> ------- -=----------- <br /> DATE------ --------- <br /> Alterations and/or recommendations:------------------------- ------- -----------•------------------------- - -- <br /> ' --- <br /> -------- <br /> A <br /> "f-411_____ <br /> r4� __. .. ----------- ------------------------------------------------------------------------- ------------------------------ <br /> FINALINSPECTIONINSPECTION BY--------- _._..._-__._ . Date---------- --- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street <br /> Stockton, California <br /> Lodi, California Manteca, California Tracy, California <br /> ES-9-2M 10-52 Revised W-2100 <br />
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