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17038
EnvironmentalHealth
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NORTH RIPON
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4200/4300 - Liquid Waste/Water Well Permits
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17038
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Entry Properties
Last modified
12/15/2018 6:55:08 PM
Creation date
12/3/2017 6:12:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
17038
STREET_NUMBER
17404
Direction
S
STREET_NAME
NORTH RIPON
STREET_TYPE
RD
City
RIPON
APN
20308021
SITE_LOCATION
17404 S NORTH RIPON RD
RECEIVED_DATE
02/26/1964
P_LOCATION
JOE AZEVEDO
Supplemental fields
FilePath
\MIGRATIONS\N\NORTH RIPON\17404\17038.PDF
QuestysFileName
17038
QuestysRecordID
1871502
QuestysRecordType
12
Tags
EHD - Public
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---------------------------------------FOR OFFcr icE q.SE: <br /> --------------------- ------------------- -------------- <br /> APPLICATION FOR SANITATION PERMIT Permit No. ._....... <br /> --------------------- -----.a11---------------=M -w.., (Complete in Duplicate) - Date Issued --- <br /> C' <br /> =7- �.����{ ,fir- v JU-This Permit Expires 1 Year From Date Issued _ <br /> ' , �f <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the wok hereeiin�describf'd. <br /> This application is made in compliance with County Ordinance No. 549. <br /> --(( <br /> J08 ADDRE AND51D LOCATION �PAQtry / ---'` - ,2Q--------------------------------- <br /> Owner's Name-------------'-j �:--------..-..-- f + Phone <br /> Address------ �._ k <br /> ContractorsName-----CO lG-1 1"'�_--- �----------- -------------------------------- -- ----------•-------------------------- ---- Phone----------------------------------- <br /> Installation will serve: Residence Apartment House E] Commercial ❑ Trailer Court ❑ Mote! ❑ Other L]Number of living units: _-_.1_- Number of-bedrooms Number of baths I----I---- __Lot size 4-C.RX�=--=----------------------- <br /> Water Supply: Public system ❑ Community system'❑ Private UT"'De4h to Water Table /5ft. <br /> Character of soil to a depth of 3 feet: Sand]Gravel ❑ Sa`nclyrl_oam, ❑ Clay Loam ❑ Clay ❑ . Adobe ❑ Hardpan ❑ <br /> Previous Application Made: (If yes,date... =1-No [ New Construction: Yes W No ❑ FHA/VA. Yes ❑ No <br /> i <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> No septic taDistance rsspool nearestied if public sewer is available within 200 feet.) <br /> ( P P P <br /> L ell_ 61 .� �f r _ I ----------- ----------- <br /> Sep C9 <br /> f -. <br /> �':� ~SIZe-` ----- ' � 1C' � q '� p shy - ---� <br /> No. of compartments------ 1]istance�r�m foundation uld.d.e th--Mate-- - --Capaaty_______--�-------"•-.-� i <br /> i �� <br /> _�'. <br /> Disposal Feld: Distance from nearest ells- Distance from foundap.on'�-r_-_ '- Distance to nearest lot line---------------- <br /> Disposa <br /> Number of lines_--=-_---- _.___ Length of mac k lire <br /> n---- --------------------------Width of trench.----- :--------------------s <br /> 6 Type of filter material-!----------------117----Depth of filter material-----------------------Total length----_-------:---------------------_------- <br /> Seepage Pit: Distance to nearest well- _"._"Distance from foundation-------------------.Distance to nearest lot line___---..-----___. <br /> ❑ Number of pits------.-----1_ Lining material----------------71__1--.Size: Diameter----------------------.Depth-----------------.-------:------- <br /> k,pw,.Mwi„�.e.r.aw....��.+ 1 1 <br /> Cesspool: Distance from nearest well-----------------Distance from foundation-----_:--___-.......Lining material--------.___-_.----------------------. 7 <br /> ❑ Size. Diameter--' ----------Depth---------------- --------------------------Liquid Capacity----------------------------gals, <br /> Privy: Distance from nearest well--------------------------- ----- i__1Distance from nearest building----_-._-----__-_-----_-..--__. --- .� <br /> I r <br /> ❑ Distance to nearest lot line--------------------------- ------- ----------, ;i----------------------------"---------------------------------------------------------- <br /> ----------------------------------------=-------------- <br /> x�-?(,-GY wt1.� CL►�G'f""f"C�) �7t1s"rrl�l� ��.AC� � <br /> Remodeling and/or repairing (describe):__41NN. R----- H 15------- - St-}----1N STf�} 1?..--_- ----Qt- --'---- <br /> 1 - I - -4t------------__--------- ---------•----•------ ---------------------- 77- M'Q.r. <br /> ------------------------------------ -------- ------------------------------------- --------------------------- --- ---------------- - <br /> -- - e..r <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 rules4and regulations of the San Joaquin LoiA Health District. <br /> :, ----- -------=-------------------- ----------------- -- �------- ------------=------ --------------(Owner and/or Contractor) <br /> (Signed)---•------ - -----• --- ------ � - -{ <br /> BY ` ----------- --f (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 /> APPLICATION ACCEPTED BY------ - 4-�-' -- -----•--•--'---------- ------------•--------------------------- DATE---------02---�49--------- - -- -------------------- <br /> REVIEWEDBY--------------------------------------- ---- ---------------------------------------- ----------------------------------- DATE----------------- --------- - -------------- <br /> BUILDING-. -PEPERMIT-ISSU,ED---------------------------- '-- I--------------- ---- DATEf"rrrr= =-- --------------------------- <br /> Alterations and/or recommendations-----------------------------------------------------------• ----------------------------------•--- ------------------------------------------------ <br /> 1r'1 +`�``I Rt I <br /> ----•---- -------------------------------------- <br /> -- <br /> ------------------------------------------------ <br />!, .Dae.. --, -s. �- �r-,--- -FINAL IN5PECT1 BY <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> F 1601 E.Maieltan Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> CS 9 REVISED 8-59 3M 3-'63 F.R.CO. _c v. <br />
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