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14984
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4200/4300 - Liquid Waste/Water Well Permits
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14984
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Entry Properties
Last modified
11/27/2018 4:40:10 AM
Creation date
12/1/2017 1:05:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
14984
STREET_NUMBER
791
STREET_NAME
WETHERBEE
City
LATHROP
SITE_LOCATION
791 WETHERBEE
RECEIVED_DATE
11/07/1962
P_LOCATION
ELBERT BATES
Supplemental fields
FilePath
\MIGRATIONS\W\WETHERBEE\791\14984.PDF
QuestysFileName
14984
QuestysRecordID
1984164
QuestysRecordType
12
Tags
EHD - Public
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FOR OFFICE USE: <br /> :-------------•-------------------------------- --------- <br /> _ --:- APPLICATION POR SANITATION PERMIT Permit No. .. ...-J�/J.�11 <br /> ---- - ---- (Complete in Duplicate) <br /> ------ This Permit Expires 1 Year Fror -Issued Da+e' Issued <br /> sit»D±�a <br /> t <br /> Application is hereby made to the San Joaquin Local Health District fora permit to construct and install the work a ein described. <br /> This application is made in compliance with County Ordinance No. 549. MA NTP-e9 <br /> JOB ADDRESS AND LOCATION.V..v_ -TH- - -.. _ d.--• j,�LS ... V.L ..Q/[�l� <br /> Owner's Name------------ --------- ,] TJ ---------- ! <br /> Address-----.... � N_JrF''' _ - 1_. .._ <br /> Contractor's Name.-- ,<'19!t-IV.EK-------••---------------- --- -------------------- ----------------•-••-- -- -•---------.----- Phone...................... <br /> -------- - <br /> Installation will serve: i Residence ❑ Apartme t House Commercial Trailer Court i S MM6 R <br /> ❑! ❑ ❑ Motel ❑ Other <br /> Number of living units: __Number=ofrbed�re rns�r_ Number-th baths J-_-_ Lot size ------ >---------� 0-••••••------•-•_- <br /> Water Supply: Public systR Com-In system Private Dept *TpWater Table #t. <br /> Character of soil to a depf 3»feet: Stind^ /G ravel -—Sand -Loa . :ala .Lam <br /> P� ❑ y I y ❑ Clay ❑.•Adobe❑ Hardpan ❑ <br /> Previous Application Made: If es,date_..---._.-._:.'_ ._ <br /> PP � I ) No� Nev;New Construction:: Yes [�/No ❑ FH�,/VA: Yes ❑ No <br /> ! r <br /> ... TYPE-OF .INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank'or cesspool permitted if public sewer is available within 200.feet.) <br /> z <br /> Septic nk: Distance from nearest well.-_1)-___Distance fro) foundation... .0.-... Mater-ai..RF_D w/ <br /> �9depth-- 0.0`0.---------- <br /> El No. of compartments-.__....Z– Size_3_�,.�_ .- i uid i -------_- ... }Ca aci <br /> Disposal Field: r1 Distance from nearest well....----Distance from foundation'. <br /> Number of lines----------... . ....._--_ _ �-�-�•---•Distance to nearest•aot J,ne____.S_-••--_ <br /> -- - Length of ea�h line-------Y0_ -.. --_---Width of trench------IKY!f---- --------- <br /> pe of filter material__._. O-C, i_Depth of filter material._-_...`....Total len th_+._.__.._: <br /> # g i � - •------ <br /> Seepage Pit: Distance to nearest well----------------------Distance from foundation....---- --__.Distance to nearest lot line---------- <br /> f <br /> ❑ Number of pits- Lining material.---------- -----------S-ize Diameter ------------Depth-------------------=-----•.------ <br /> Cesspool: Distance from nearest well__-....._.-.-..Distance from f0Idaf, ----[_ .L►fining materi5l-------------------------- <br /> -----=----- ,. <br /> ❑ Size: Diameter--------•-----------------------------Depth---------- --------- .t. l{ ` -------I-----Liquid Capacity-----------------------------gafs.N <br /> Privy: Distance from nearest well.- _,----------------------------------JL_-_--- .istance-from!Barest building <br /> ding.------...._------------ <br /> -------------- <br /> ❑ Distance to nearest lot line <br /> ----------- <br /> Remodeling and/or repairing (describe):............I----------- <br /> -------------------- <br /> .- - . . <br /> .,.- ----- ----•----------- --•----- <br /> " = <br /> ------ ------•---••-------•---------- ----------------• -•------------•----•--------•----------------•--------- --------------------------------------......•--------------------------- <br /> I I <br /> I hereby certify that I have prepared this application and that+he work will be done in-accordance with San Joaquin County <br /> ordinances, State lawsl and rules and regulations}of the San Joaquin Local Health,Districf. i <br /> I 1` <br /> _ y e <br /> (Signed)-- •--- -- •-------------------------- `r Owner a n ract I <br /> ---- -- --- ----- ------ -=---- -- ` rid/or•�Co <br /> or <br /> (Plot plan, showing size of lot, location of sys em-in relation +owe Ili buildings, ei can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY _ <br /> APPLICATION ACCEPTED BYt =fl'-------------------------------------------------------- -------`rDfA3-E_�.rf�.-r7 <br /> REVIEWED BY----------_----------- <br /> ----------------------------------------------------------------------- <br /> �. y_- <br /> •----------•------ 'tDATF- --- Mt <br /> BUILDING PERMIT ISSUED-- - ----------------------- <br /> •- - --��-----��fa3........................... <br /> --------------- --- ................. <br /> ----o -- -- ---------- -•--: DATE.------- <br /> Alterations and/or recommendations:-..-_.- �AN�4 -_[A__f( i�_ l+1p7`_•-Fid(!�py�.�T�.�f�.t7`�(Vq���, <br /> -----------------------�1 --- .Sr n 4�xC0-4.Va-TC_: -------AS------.�5P_C_&..VA(;;+�:? �..)� ....... <br /> 4I - <br /> -�-•-•-•- ------------ ------•------------- -�------PRS-�R�s....�-�t`A-AtA ---�0T---�{�.rte..�-�.Fr..N�r��-�.� �l"'�-'f�_,o-�--------------- <br /> ----------- ----------- <br /> :.----- <br /> I�a <br /> FINAL INSP TION BY:. - Date---- <br /> SAN <br /> ate---SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 Wed Oak Street; g ]24 Sycamore Street ZOS Wad 911h Street <br /> 1 <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> ES 9 REVISED 8-59 2M 5-62 ATLAS „. <br />
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