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FIELD DOCUMENTS AND WORK PLANS 1988
Environmental Health - Public
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2900 - Site Mitigation Program
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PR0009002
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FIELD DOCUMENTS AND WORK PLANS 1988
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Last modified
2/22/2019 9:26:14 PM
Creation date
2/22/2019 2:35:11 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
FileName_PostFix
AND WORK PLANS 1988
RECORD_ID
PR0009002
PE
2960
FACILITY_ID
FA0004040
FACILITY_NAME
SPX COOLING TECHNOLOGIES INC
STREET_NUMBER
200
Direction
N
STREET_NAME
WAGNER
STREET_TYPE
AVE
City
STOCKTON
Zip
95215
APN
14331007
CURRENT_STATUS
01
SITE_LOCATION
200 N WAGNER AVE
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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• APPLICATION FOR PERMIT • <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT PAYMENT <br /> SAN'JOAQUIN LOCAL HEAJArH(�ISTRICT 1601 E. HAZELTON AVE., STOCKTON, CA RECEIVED <br /> ENVIRONMENTAL E�I it SION Telephone (209) 466-6781 <br /> SPECIAF,RI�tI PERMIT EXPIRES 1 YEAR FROM DATE ISSUED SEP 12 1988 <br /> � (Complete in Triplicate) <br /> ENTAL HEALTH <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and/or install R.,rkOdR <br /> � s lication is <br /> made in compliance with San Joaquin County Ordinance No.549 for sewage or No. 1862 for well/pump and 6 an Joaquin <br /> Local Health District. 51,vec/f1/1 <br /> Job Address (LGlrtz N S 44r s7 �y�z/ ,A 'YY(G/ZO/7�/�� City��TJC{c,%/ry/ Lot Size PM <br /> Owner's Name' `� " J: "" Address /_.Y .✓!/YG��-!''L CC.PL^z'"C Phone _ <br /> Contractor/4e/lf%Jc (/4/?fJt-i!tyL'Y Address [:"11cz54- 'FiL`X License No.S?1337 Phant;y=T-rem <br /> TYPE OF WELL/PUMP: NEW WELL _ WELL REPLACEMENT ❑ DESTRUCTION ❑ <br /> PUMP INSTALLATION�e SYSTEM REPAIR ❑ OTHER ❑ <br /> DISTANCE TO NEAREST: SEPTIC TANK SEWER LINES DISPOSAL FLD. PROP. LINE <br /> FOUNDATION AGRICULTURE WELL OTHER WELL PITS/SUMPS <br /> INTENDED USE TYPE OF WELL PROBLEM AREA CONSTRUCTION SPECIFI;;Q,fS / <br /> Industrial ❑ Open Bottom FJ Manteca Dia. of Well Excavation Dia. of Well Casing <br /> ❑ Domestic/Private ?'Gravel Pack ❑ Tracy Type of Casing P41c- Specifications 1 <br /> FI Public rl Other�/f e,?ljly fl Delta Depth of Grout Seal42 Type of Grout <br /> I I Irrigation _.Approx. Depth I I Eastern Surface Seal Installed by <br /> Repair Work Done (.1 Type of Pump t UQ/Y1 H.P. %7 State Work Done— T. <br /> Well Destruction ❑ Well Diameter Sealing Material (top 50') ` <br /> Depth Filler Material (Below 501 — <br /> TYPE OF SEPTIC WORK: NEW INSTALLATION I I REPAIR/ADDITION I I DESTRUCTION I I (No septic system permitted it public sewer is \ <br /> available within 200 feet.) �• <br /> Installation will serve: Residence— Commercial __ Other 1/ <br /> Number of living units: Number of bedrooms_ <br /> Character of soil to a depth of 3 feet: — Water table depth <br /> SEPTIC TANK ❑ Type/Mfg _ Capacity No. Compartments fa� <br /> PKG. TREATMENT PLT. Cl Method of Disposal <br /> Distance to nearest: Well Foundation Property Line <br /> LEACHING LINE Cl No. & Length of lines Total length/size <br /> FILTER BED ❑ Distance to nearest: Well_ Foundation Property Line <br /> SEEPAGE PITS I I Depth ____Size _. Number <br /> SUMPS 1_7 Distance to nearest: Well _ Foundation Property Line <br /> DISPOSAL PONDS ❑ <br /> I hereby certify that I have prepared this application and that the work will he done in accordance with San Joaquin county ordinances, state laws, and <br /> rules and regulations of the San Joaquin Local Health District. j <br /> Home owner or licensed agent's signature certifies the following: "I certify that in the performance of the work for which this permit is issued, I shall not <br /> employ any person in such manner as to become subject to workman's compensation laws of California." Contractor's hiring or sub-contracting signature <br /> certifies the following: "I certify that in the performance of the work for which this permit is issued, I shall employ persons subject to workman's compensa- <br /> tion laws ofCalifornia." <br /> The applicant must II for reguked-mspections. Complete drawing on� r" '�S_y <br /> se si . <br /> r <br /> Signed X �--- Title: ��'� ' Date: <br /> � FOR/DEPARTMENT USE ONLY Q'�( <br /> Application Accepted by f/ Date Area <br /> V Area <br /> Pit or Grout Inspection by ///�J p,p-y_ Date /JF,iinnal Inspection by ppgg+ Date <br /> Additional <br /> y— <br /> Additional Comments: S� 117ze �/d1'fC-��fhtc(L/� / '-Cig /� S O 'j1^/til/N.H <br /> ❑ Stk 466-6781 ❑ Lodi 369-3621 ❑ Manteca 823-7104 ❑ Tracy 835-6385 <br /> Applicant- Return all copies to: Environmental Health Permit/Services 1601 E. Hazelton Ave., P.O. Box 2009, Stk., CA 95201 <br /> FEE <br /> N <br /> FO AMOUNT DUE AMOUNT REMITTED CK RECEIVED BY DATE PERMIT' O. <br /> x.EH 1331IREV.1/x51 +'C <br /> EH 1t-M — <br />
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