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SR0079735
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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SR0079735
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Last modified
4/11/2019 1:13:52 PM
Creation date
4/11/2019 12:06:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0079735
PE
4222
STREET_NUMBER
17508
Direction
E
STREET_NAME
FRAZIER
STREET_TYPE
RD
City
LINDEN
Zip
95236
APN
06510008
ENTERED_DATE
10/10/2018 12:00:00 AM
SITE_LOCATION
17508 E FRAZIER RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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DAfonskaia
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EHD - Public
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Site Address: 17508 E. FRAZIER ROAD Record ID SR0079735 <br /> Date: 10/12/2018 <br /> ADDRESS OR LOCATION: 7J <br /> OWNER NAME: �� ("�'v? <br /> SOIL TYPE: <br /> REMARKS: <br /> it <br /> 1. (SHOW WELLS AND STRUCTURES) <br /> - <br /> (�� <br /> FT <br /> III�I FI If I - <br /> ED <br /> SOIL PROFILE(IF REQUIRED) <br /> De th Soil Type Depth Soil T e De th Soil Type Depth Soil Type Depth Soil Type <br /> Test Hole#1 Test Hole#2 <br /> ParcelI Diameter: 0 in Depth Z in Parcel Diameter in Depth- in <br /> TIME F i`iNf, WATER DROP REFILLED (�:,� <br /> Lr.•J ._ oirt�; W;,Irr.fleC.P f�lnri Fn <br /> g_C_' , <br /> 0 <br /> C7- <br /> �I . �L> ,1(rD <br /> ERCOLATION RATE: min/in PERCOLATION RATE: <br /> ECOMMENDED SEPTIC AREA: l Li<JrJJ .: RECOMMENDED SEPTIC AREA: min/in <br /> TEST PERFORMED BY:J—ot L?1&24l Pws X17 Phone: <br /> EST CERTIFIED BY: Phone:' Date <br /> OBSERVED BY(RENS): da arc �„, Phone 7Date <br /> C . f <br /> 'EHD 42-03 REV 11009 �� ��' I Date �(y�11 I L S{ <br /> Naseem Ahmed, Environmental Health Specialist Page 1 of 1 <br />
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