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19317
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MICHAEL
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2024
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4200/4300 - Liquid Waste/Water Well Permits
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19317
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Entry Properties
Last modified
12/25/2018 10:12:58 PM
Creation date
12/3/2017 2:27:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
19317
STREET_NUMBER
2024
STREET_NAME
MICHAEL
City
STOCKTON
SITE_LOCATION
2024 MICHAEL
RECEIVED_DATE
07/27/1965
P_LOCATION
JIMMY MARTIN
Supplemental fields
FilePath
\MIGRATIONS\M\MICHAEL\2024\19317.PDF
QuestysFileName
19317
QuestysRecordID
1851397
QuestysRecordType
12
Tags
EHD - Public
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'FOR OFFICE USE: _yQ `111, 1 <br /> ----------------------------------- ------- if `�_,� -�. <br /> __-._................................................._ APPLICATION FOR SANITATION PERMIT Permit No. .....�.-.�--- <br /> ------------°-------------------------------------------- (Complete in Duplicate) Date Issued <br /> --------------.-----------------..-------------------.....' 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 instal!the work herein descrbed. <br /> This application is made in compliance with County Ordinance No. 549. ` <br /> JOB ADDRESS AND LOCATION---------it y _ ` <br /> Owner's Name--------yr - G• -- --------------------------------------- ------= ------ Phone,l�_A/_21AA--�--- i <br /> Address---------a-1-�f------- ��1�:� -,/— <br /> Contractor's Name------ - ----------------------------------------- ----------------------- Phone--- ------------ <br /> Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ i <br /> Number of living units: __l____ Number of bedrooms ___1____ Number of baths ---/ Lot size --__--1 - - _----- __6 <br /> ----------------- <br /> Water Supply: Public system P-160mmunity 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 ❑ <br /> r <br /> Previous Application Made: (If yes,date...._-------------__) No ❑ New Construction: Yes ❑ No ❑ FHA/VA: 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 w�'-----Distance from foundation-_ _-_- Material------------------------------------- ----------- <br /> No. of compartments_________ -_Size-------_----------_-------------Liquid depth---------_________--------Capacity--- <br /> Disposal field: Distance from nearest -------Distance from foundation_-_.-/-U.-------.Distance to nearest lot line----__- _ -- <br /> Number of lines---F--------../-_ ----------------Length of each line_- �2 ------Width of trench.--.------g-_",_//------------ <br /> Type of filter material-a-X,_4 ---__Depth of filter material-----/5;�..---------Total length--------- ------------------- ' <br /> Seepage Pit: Distance to nearest well---`� ---.-----Distance from fo ndation----jib-_.........Distance to nearest lot <br /> Number of pits....!-.�-------------Lining material_.W�,c/7 .Size: ---Depth------------60--------------- f" <br /> Cesspool: Distance from nearest well-----------------Distance from foundation---.---------------.Lining material_._.---------------_-.---.----_---. <br /> ❑ Size. Diameter -1 -------------- -- Depth--------- - -- ---------------- - - ----------------Liquid Capacity----------------------------gals. <br /> Privy- Distance from nearest well--------:------.----------------------------------Distance from nearest building----.---_-------.-_-----_---.------.---. <br /> ❑ Distance to neare!st lot line-- ------------------ ---- ----- -------------------------------------- ----------------------------- <br /> Remodeling and/or pairing (describe):-.- ...__, --_ ..� __4L�.� <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 /> (5t ned <br /> g --------------------j -------------------------------- ---------------------------(Owner and/or Contractor) <br /> EY �- � - -- ------- f GL -�- ----------------------------------(Title)---------------------- ---------------- --...... -- <br /> (Plot plan, sh0 ng size of lot, locat' of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> 1 FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY L� - -----A-i-------------------------------- DATE- -7-------------------- ---- k <br /> REVIEWED BY------------------------- ------ - ----------- ----- - -------- -------- -------- ---------- ----------------- DATE <br /> BUILDING PERMIT ISSUED------------- '------------------- ------ DATE--------- --------- --------- ------------------------------- <br /> Alterations and/or recommendations---------- ------------------ ------- --------------------------------------------------------•--- ---- ------ ------------ <br /> '��'--/ <br /> eC�.hc - ------- --------------------------------------- --------------------- --------- -------- -------- ------------------�-----------��----------------- ------- <br /> Pr aN.-I <br /> ate4 - U� . G.C- ¢- if <br /> k.µ . crcu /c nQ / J�`q1c c,� ���r j ,f b-'eA. el,4 eg <br /> PK: p�ctBY-.—r�/z'i e = Cil t / ' <br /> INL th5 T -- .......... --...---- -- --- - --- ------ Date- /1 ------------------ <br /> F SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> F.P.EO. <br /> A <br />
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