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8299
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MICHIGAN
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1987
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4200/4300 - Liquid Waste/Water Well Permits
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8299
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Entry Properties
Last modified
8/1/2019 11:10:56 PM
Creation date
12/3/2017 2:29:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
8299
STREET_NUMBER
1987
Direction
W
STREET_NAME
MICHIGAN
STREET_TYPE
AVE
City
STOCKTON
SITE_LOCATION
1987 W MICHIGAN AVE
RECEIVED_DATE
11/30/1956
P_LOCATION
RONALD FUGUA
Supplemental fields
FilePath
\MIGRATIONS\M\MICHIGAN\1987\8299.PDF
QuestysFileName
8299
QuestysRecordID
1851677
QuestysRecordType
12
Tags
EHD - Public
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APPLICATION TOR SANUA N PERMIT Permit No. _---?.. <br /> Cl (Complete in Duplicate) f -, 9 <br /> Ida+e Issued ..-.i r'� <br /> Applica4-ion-'is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. i <br /> This application is made in compliance with County Ordinance No. 549, t <br /> JOB ADDRESS-AND LOCATION..__�.ryry. .Q , <br /> Owner's Name - _ - '�"" ------ Pho e----------- - -•-•• <br /> UI} -�- g <br /> Address.........................C4' 4 �. <br /> ------------------------------------------------------------------------------------------ --•-------------------- <br /> Contractor's Name . - ±^R.► - -----------------------------------------1--------------- J <br /> Phone. S.S <br /> Installation will serve: Residence Apartment House ❑ -Commercial ❑ Trailer Court ❑h Motel ❑ Other ❑ <br /> Number of living units: _--i._-. Number of bedrooms - -:. Nuri ber of baths_1.... Lot size .... _ -- --2, _� __ i <br /> j ------------------- <br /> Water Supply: Public system Community system ❑ Private ❑ Depth'to Water Table �f1-- ft.' <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Gay Loam ❑ Clay ❑ Adobe Hardpan <br /> Previous Application Made: Yes ❑ No F�"New Construction: Yes R''rNo ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> w. (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well---------------- Distance from <br /> . foundation-------------------- <br /> _Mate/lal.No. of compartments-------- - Size : .-. Liquid depth. .-�.'..- <br /> -...._-.-.-.` <br /> Disposal Field: Distance from nearest wells-------------..Distance from foundation_ ....Distance to nearest lot line-'------------- t <br /> L_-Z 4 Number of lines-.-------/---- ..._.__Length of each line-._ -----._------- -------Width of trench:-------._f. `-�,._•-_ <br /> Type of filter material-------------------------Depth of filter material---- length <br /> - Total --------------------------- <br /> ------ <br /> ------•------ -•----------,�-�---�•- ---- ,�„V <br /> ��....D*tante to nearest I' t�line_.....'-....... <br /> Seepage Pit. Distance to neacesLwell.. _-----Distance fFom foundation_.-. _. -� <br /> Number of pits.-....__._....- .____Lining material.-----Size: Diem ter................. <br /> Depth <br /> Cesspool: Distance from nearest well.-.._.__.....-_Distances oupda#on.................._Lining material- _---_-- <br /> ----- <br /> ❑ Size: Diameter----- - ------------------------- ---Depth-------------------------------- -------------------Liquid Capacity----------------------------gals,N <br /> Privy: Distance from nearest well------------ ---------------------------------Distance from nearest building------------------------ <br /> ❑ Distance to nearest lot line- - ._. --_;."-'r-�'”r <br /> Re Jelin and or repairing( descri}ie :...................... . �_t' <br /> --------• --- • -.---- ------------------------------•----------•--------•---------•----------•-•----- - <br /> --------------- ---•---•------------•--------•------------- ------------•---•----------------------------••------------•----------••----------- •------- <br /> --- i <br /> ---•-----------•--------------•-------------------•-----•• 1-,------------------------------------------------------------------------------------- •-----------------••---------•-----------•------------------------ - <br /> v <br /> I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin Co my <br /> ordinances. State laws, and rules and regulations of the San Joaquin Local Health District. <br /> w <br /> (Signed)--- i - -------��' - --------- -.(Owner and/or Contractor) <br /> 4 ------------- ----------------------------(Title)------•----------� - <br /> (Plot plan, showing size of I t, Iota+ion of system in relation to wells, buildings, etc:, can be placed on reverse de). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY---- 0----------------------------------------------------- DATE---------- = y r ' <br /> REVIEWED BY - ------. -- ---- -------•---- --------------•-- ----- DATE------- .. c .F a 1 <br /> t <br /> BUILDING PERMIT ISSUED-----•----------------------------V----------------------------------------------- ------ DATE----------- <br /> Alt tris and/®r recommendAtions:--n- ___.--_-.�!-.. --- ` <br /> f <br /> 1----------------------------- - <br /> -- -- -- ---------'-------------`'--r-. <br /> ---------- ------ ----------------------------------------------------- <br /> ..--------•^-----------------------•---------------•---------.....-•----------------._-.-----------._---- <br /> .. <br /> FINAL INSPECTION BY:......- - C� <br /> '_c.G�t. Date---.._Z ,-1...... <br /> -------------------- <br /> SANdOAQUIN LOCAL HEALTH DISTRICT <br /> i <br /> 130 South American Street 300 West Oak Street 132 SyeaMors Street 814 North "C" Street i <br /> Stockton, California Lodi, California Manteca, California Tracy, California 4 <br /> i <br /> E5�9 745446 ATWptlp <br />
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