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4200/4300 - Liquid Waste/Water Well Permits
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833
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Entry Properties
Last modified
8/4/2019 11:38:08 PM
Creation date
12/2/2017 12:50:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
833
STREET_NUMBER
5965
STREET_NAME
GLEN
STREET_TYPE
ST
APN
10811021
SITE_LOCATION
5965 GLEN ST
RECEIVED_DATE
08/02/1951
P_LOCATION
NOMELLINI CONSTRUCTION COMPANY
Supplemental fields
FilePath
\MIGRATIONS\G\GLENN\5965\833.PDF
QuestysFileName
833
QuestysRecordID
1792736
QuestysRecordType
12
Tags
EHD - Public
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33 <br /> APPLICATION FOR SANITATION PERMIT , <br /> (Complete in Duplicate) <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 ap lication is made in compliance with County Ordinance No. 549. ` f <br /> 74 & s CZ-2, s 1O� Glenn Rd <br /> JOB ADDRESS AND LOCATION-----Gray__flat---top---on__north__west___ _orner___Qf__S_ ' ---Road--- ____________ <br /> in Swain6-gins <br /> Owner's Name Q!?Ze111 1jr_QS] r�o•----- ----------- --------------------------------- Phone---------9957-1-------------- <br /> Address--------9 91-14=t45Q_ ad:4 <br /> Contractor's Name----�,------ 10-------a0a4--INC-•---------•-------- _-------------•---------- Phone-----9..960-7----------- <br /> Installation will serve: 'Residence K] Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: -M Number of bedrooms ® Number of baths ❑ Lot size--------601-x.1Qt-------------------------------- <br /> Water Supply: Public system ❑ Community system X Private ❑ <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobes] Hardpan <br /> r r <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 well-- MEL--_Distance from foundation--------100,---.Material--- e-_BrIck---------------- - <br /> xx P 2 Capacity Q--- iz 56e.-x36! 63" Liquid depth----5Z..-------- ' <br /> No. of compartments _Ca acit g0� Cfi' e r,. <br /> Cesspool: Distance from nearest well_________________Distance from foundation------------------- Lining material-------------------------------- <br /> Size: <br /> _------____----___-_--___----Size: Diameter--------------------------------------Depth---------------------------------------------------- <br /> :Privy: Distance from nearest,well-------------------------------------------------Distance from nearest building------------------------------------- <br /> F1 Distance to nearest lot line------------------------------------------------ <br /> Seepage Pit: Distance to nearest well----------------------Distance from foundation--------------------Distance to nearest lot line-_-__---_--_-_ <br /> ❑ Number of pits----------------------Lining material-----------------------Size: Diame=er------------------------Depth-------------------------_>E-_l1 :kVA <br /> Disposal Field: Distance from nearest well__-_N-01le-.Distance from foundation-----24---------Distance to nearest lot line___--_5---__ l <br /> Number of lines__-__---_-_ <br /> � �.---���------------Length of each line---SQ---.��--3��---.Width of trench------2--------------------- <br /> Type of filter material_--�.-z_-_---Rk-__-Depth of filter material----____-_-18_--_- <br /> Remodeling and/or repairing (describe) Ne-W --ina-ta .lation---------=--------------------------------•------------------------------------------------ <br /> ------------------ <br /> - -..._ <br /> --------------------------------------------------------------------•---------------------•-----------------------------------------------------•-----------------------------------------------------........ ------- <br /> ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> 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 /> (Signed) A zc`' SONS-� INC. ------------•---------------------'--------------------- Contractor) <br /> r�. <br /> $Y----------- -- .------------------ --''----------�-- ------ ---- --- ------ --�--------------------------------------(Title)-----�'i.S_�llCl&t Qr----------------------------- - <br /> (Plot plans, show size of lot, location of sys min relation to wells, buildings, etc., must be filed with this application). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BYV ------------ ---------------------------------------- DATE------t ----------------- <br /> ----- � ^ <br /> -- <br /> REVIEWEDBY------------------------------------------------ ----------- --------------- ------------------------------------------ DATE--------------------------------------------------------- <br /> BUILDING PERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE------------------------------ <br /> Alterations and/or recommendations------------- ---------------------------------------------------------------------------------------------•-----------••-•------------------------------------ <br /> ------------------------------------------------------------------------------------------------------------------------------------------------------•--------------------------------------------------------------------- <br /> ---------------------------------------------------------------------------------------------------------------------------------------------------------•----------------------------------------------------------------- <br /> ----------------------------•--•---•------------------------------------------------------------------------•---------------------------------------------------------------- ----------------------------------------- <br /> PERMIT No---- -.3 -------- ISSUED------- _- -Z-_-- --1__------(Date} FINAL INSPECTION BY--------------- ' <br /> --------------------------- <br /> Date--------------------- - <br /> --------------------------------------------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street <br /> Stockton, California <br /> ES-9-2M 9.50 W-1639 <br />
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