My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
21777
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
M
>
MARSH
>
5757
>
4200/4300 - Liquid Waste/Water Well Permits
>
21777
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
1/7/2019 10:14:27 PM
Creation date
12/3/2017 1:32:42 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
21777
STREET_NUMBER
5757
Direction
E
STREET_NAME
MARSH
City
STOCKTON
SITE_LOCATION
5757 E MARSH
RECEIVED_DATE
05/10/1967
P_LOCATION
CLARENCE DILLARD
Supplemental fields
FilePath
\MIGRATIONS\M\MARSH\5757\21777.PDF
QuestysFileName
21777
QuestysRecordID
1846334
QuestysRecordType
12
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
2
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
FOR OFFICE USE: <br /> 'S4/ ------ ° J---- Permit No. .!77. <br /> _-" - - - iy APPLICATION FOR ;;l�ITATION PERMIT <br /> -- <br /> ,� �yQ_�( -- ---- --�[------------ (Complete in Duplicate) Date Issued <br /> 1-_------------------------------- .__ This Permit Expires 1 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 /> JOB ADDRESS AND LOCATION. _.--� _._�-`I------------e•-------- <br /> Owner's Na r Phone-----------------------------•------ <br /> `` /� e <br /> Address / / -- --- --- ------ ------------ P <br /> I� <br /> Contractor's Name 1K 2 <br /> •--� & �"GL , ❑ ® I <br /> one.-- -. <br /> Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel Other <br /> Number of living units: ../-_ Number of bedrooms _>F___ Number of baths _/_. Lot size ____ _cX-1- p---------•-•-•------- k <br /> Water Supply: Public system ❑ Community system N Private ❑ Depth To Water Table 7.57'ft. U <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobej' Hardpan ❑ <br /> Previous Application Made: (If yes,date--------------------) No W New Construction: YesX No [IFHA/VA: Yes ED NO (A E <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer <br /> wer is available within 200 f <br /> Septic Tank: Distance from nearest well_ SJ____.Distance from found``ation___ <br /> 6--------- -- <br /> No. of compartments------o2 ---- Size ---Liquid de h P-- P y l <br /> ......_ <br /> Disposal Field: Distance from nearest well-.%1V --- -Di�tance from foundation__j�__...------Distance to nearest lot line___s�. <br /> �, <br /> Number of lines-______�____ Le gth of each line_..----T�------------Width of french-----.oZ__IK_`�.-._______..-- <br /> - <br /> if <br /> Type of filter material... ___-----Depth of filter material____ ----- length_.___ •- <br /> Seepage Pit: Distance to nearest ---- Distance from r•foundation__.,10-f_..___.Distance to nearest lot line...... <br /> �---- <br /> Number of pits---- ---.---------Lining material__ ------Size: Diameterg.�._" )--Depth--___a.�S"e-- ------ <br /> Ces pool: Distance from nearest well______-"_____..._Distance from foundation___________________Lining material__.----------------------------------- I'. <br /> ❑ Size: Diameter-------------------------------- Depth----------------- ----------------- ._------Liquid Capacity -------•----gals. <br /> Privy: Distance from nearest well-------------------------------------------------Distance from nearest building------------.-_____-_-------.-----..------ <br /> ❑ Distance to nearest lot line-............................................ { ---------------•-------------------------------------------- <br /> Remodelin and/or repairing describe --------------------••-------------•--------- ------------;'---•-••------•-------•-------- <br /> -------•---•---•-•------•-•------------ <br /> ----------------------------------------------•--------------------- <br /> i + z�' <br /> ------------------------------------------------------------------- <br /> ___ ------------------------------------------------------------- <br /> I hereby certify that 14ye 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 /> � - <br /> ia�--"---- ---••••-----------.(Owner and/or Contractor) I <br /> (Signed)---------------- <br /> ----- Title----------------------------- - -- ..-- -------------- <br /> (Plot plan, showing sire 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------ ---rZol <br /> ----------- ----------------------------------------------- DATE-------`--- - -- -- -/------------------------------ <br /> REVIEWEDBY-------------------------- - DATE-----------------------•------•-----------------•---------- <br /> BUILDINGPERMIT ISSUED-------------------------------------------------------------- -------------- DATE----------------------------- ------------=------------:--- <br /> Alter,ation and/or recom end tion : --- - ----------.....-----•----------------""--------••--•"-------- ------"----------------------------------------- <br /> // •-"--•-- •----------------------•--•-----•---•-------•--------•------------.--•- <br /> _ __ g- <br /> : - - _:::::_::: ..::: --------- <br /> FINAL INSPECTION BY:- -._=1...�.. ------ Date - <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT r <br /> 130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 91h Street <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> ES 9 REVISED 8.59 2M 5-62 ATLAS <br />
The URL can be used to link to this page
Your browser does not support the video tag.