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19852
EnvironmentalHealth
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WILLOW
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4200/4300 - Liquid Waste/Water Well Permits
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19852
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Entry Properties
Last modified
12/27/2018 10:09:35 PM
Creation date
12/1/2017 1:27:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
19852
STREET_NUMBER
1801
Direction
E
STREET_NAME
WILLOW
STREET_TYPE
AVE
City
STOCKTON
SITE_LOCATION
1801 E WILLOW AVE
RECEIVED_DATE
11/29/1965
P_LOCATION
ACME PAINT & BODY SHOP
Supplemental fields
FilePath
\MIGRATIONS\W\WILLOW\1801\19852.PDF
QuestysFileName
19852
QuestysRecordID
1987022
QuestysRecordType
12
Tags
EHD - Public
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FOK OFFICE USE: <br /> f/ -A --------------- ----------- APPLICATION FOR SANITATION PERMIT Permit No. .�/..--- -"- <br /> ---------------------------------------------------- [ p g . - ) <br /> --- ------------- <br /> Cam late in Duplicate) Date Issued �_.���S <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 install the work herein described. <br />„_.,,,"•This application..is,.made.in,compliance-with C y.Ordinance 549.- „-0, . ��._. --- --- .-- , T= <br /> I <br /> JOB ADDRESS AND OCATION__� - `' :G ------------------------------------------- <br /> --------- _ <br />,.....w r.� L == - - <br /> Owner s.Name - - ------- <br /> rr ------•I <br /> ---•--- --- <br /> Address-----i---------- _4�_ --- --•--•--------- �c'[�'C ------- - --- - T a_.._ .Xy�. Phone4 . <br /> Contractors Name-------------- <br /> Installation <br /> Apartment <br /> ❑ ❑ ❑ 0 her ❑ <br /> al <br /> well seive Residence , umbert f bedroomis--Z.'_CNumberlof baths railer Court e ' o �� t <br /> ----------------------------- <br /> Number of living units: <br /> Community system ate De I <br /> Water Supply: Public s s e j y y ❑ e ❑ pth to Water Table "- ft. <br /> PP y: � . . �yti. m .. un em � . <br /> k Adobe Hardpan <br /> Character of soil to a.depth.of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ ❑ <br /> M z y New Construction: Yes ❑ No FHA/VA: Yes ❑ No� <br /> Previous Application Made:`Ilf ygs,dcite:.......... No.� <br /> IOF IN, "AND SPECIFICATIONS-1— <br /> TYPE <br /> (No septic tank or cesspool permitted if public•sewei•,is available within 200 feet.) } <br /> I # s: .., <br /> Septic Tank: Distance from nearesr well___ _________ Distance from foundation-------- -----------Material------- ------------------------------------ -- <br /> ' D 6, i5�f No. of compartments,---.�'...........--"Sizer-£=--- •--- Liquid depth-----------------. Capacity <br /> Disposal Field: Distance from nearest well............... .Distance from foundation__"_-__._--_.__"_.Distance to nearest lot line_.______..______. <br /> ❑ EXLS'��N6 Number of lines-----------------------------------Length of each line. __ Width of trench. <br /> -.-- - - <br /> $ Type of filter material-------------------------Depth of filter material--------------. """"---Total leng+h_.______...------=-----------------r " - \ <br /> 1 ____-_-_Distance to nearest lot line- <br /> Seepage Pit: Distance to nearest well..l3��_N_ "--Distance from fout<da#ion__,lQ <br /> Linin material_.ft.�1�-.Size: Diameter.-,?.tri-"."" ""-"Depth--- <br /> �, � Number of pits --- g 7.S7 ------ <br /> � Cesspool: Distance from nearest well_.___.____-..__Distance from foundation.................._Lining material.._.-___....__.._---------"-"" ala. <br /> El I,i Size: Diameter------------- ------------------------Depth----------------------------------------------------Liquid Capacity---------------------- 9 <br /> Privy: 4 Distance from nearest well__--------------------------------------- ------Distance from nearest building------------------------------------------ <br /> ------------------------ <br /> ------•--------------. , <br /> r � Distance to nearest lot line----- ------------------------ - --------------- - ------------- ---------------------------- <br /> Remodelingland/or repairing (describel-------------------------------------- - ----------- ---------------------------------------- -------------- -------------------------•- <br /> 4 - ----- -------- <br /> - -- ----- --- <br /> ! ------------------------ ------------------------------------------------------ --------------------- <br /> -------------------------------------- <br /> --- ------------ - <br /> I � Cr u�...� e�- -------- ------ S`al— ----- b�� 7�r`�v p <br /> ----------------------- - -- <br /> Ihereby certify ve prepared` this app icati and that the work will be done in accordance with San Joaquin County <br /> ordinances, $tate la , and ules and ulati ns oft San Joaquin Local Health District. <br /> i _ caner and/or_ / r Contract ) <br /> a <br /> �. �--- `-- -- - ---- ---- -- ----- -- - - ----------(Title)--------- ------------ ---- ---------- <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be place n reverse side). <br /> I FOR DEPARTMENT USE: ONLY <br /> i APPLICATION ACCEPTED BY---"----- --------------- DATE------------1// --9 ------- <br /> ` REVIEWED BY-------------------------------------------------- --------------------------------------------------------------------------- DATE--- --------"-------------------------------------------- -- <br /> DATE------------------------------------------------------------ <br /> I 1 <br /> BUILDING PERMIT ISSUED------------------------- �;�----- -- -- - - - <br /> �' _ _ <br /> Alterations and/or recommendations: �1. ` � <br /> ------------------------------------------------ <br /> ---------- <br /> --------------------------------------------------------------- <br /> ---------------------------------- ---- -------"- --- -------------- ------ <br /> --- -----=---------- <br /> �f���� <br /> { ------------------ Date----------------- - -- --- --------- ------------- -- <br /> FINAL INSPECTION BY:..... .... .. ... ..--""-- <br /> t SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E.Haxelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street <br /> i Stacklon,California <br /> Lodi,California Manteca,California Tracy,California <br /> i <br /> F.F.CC. <br />
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