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p , � �-n t -: i x'�•:s�i ,?}e i"�• '�''� �xv rr � lr- ,.q x' �a'r:�as7r-�.-�, '`'.3�.,�.v' r.�,,.u.i so-.-..i �!.' Y 5 ' .. .�... .�.�.i!�.+1{,i=�Y�i'':'.»..�,..crst'..��"�.#ra�'� h��'. '� ��....�er'�Sb'��+'a.w�,�:r.1 xd• '. .. 445 N SAN JOAQUIN, PHONE (209)468-3420 P 0 BOX 2009, STOCKTON, CA 95201 PERMIT EXPIRES 1 YEAR FROM DATE ISSUED F (Complete in Triplicate) Application is hereby made to San Joaquin County for a permit to construct and/or install the work herein described. This application is made in compliance with San Joaquin County Ordinance No. 119 and 1862 and the Rules and Regulat one.of Sa❑ jJoaquin County Public Health Services. Job Address 3732 E. Carpenter Rd. _ city t5 ockton Lot Size/Acreage -� Son Contractors 8420 Pr Phone ` Owner's Name Address - 12681 Contractor Hennings Bros., __Address 3525 Pelandale, Mad, License No. 2917L1_3—Phone 545-1185 TYPE OF WELL/PUMP: NEW WELL X( WELL REPLACEMENT n DESTRUCTION 0 Out of Service well ❑ PUMP INSTALLATION )X( SYSTEM REPAIR ❑ OTHER ❑ Monitoring Well ❑ + DISTANCE TO NEAREST: SEPTIC TANK 133"+ SEWER LINES DISPOSAL FLD. 33?,1 PROP. LINE 13 j FOUNDATION AGRICULTURE WELL OTHER WELL PITS/SUMPS r FI INTENDED USE TYPE OF WELL PROBLEM AREA CONSTRUCTION SPECIFICATIONS n Industrial ❑ Open Bottom Q Manteca Dia. of Well Excavation ia. of Well Casing u �Womestic/Private KXGravel Pack ❑ Tracy Type of Casing_ PVC I l -r$pe ifications I fin S�h 1 r l f'1 Public I 1 �tf,er fl Delta Depth of Grout Seal pa of Grout BPnnn l 1 P GG y, I i Irrigation Approx. Depth 1 I Eastern Surface Seal Installed by driller Repair Work Done L] Type of Pump H.P. __�� State Work Done _ Well Destruction ❑ Well Diameter Sealing Material Depth Depth Filler Material & Depth 4 TYPE OF SEPTIC WORK: NEW INSTALLATION I 1 REPAIR/ADDITION I I DESTRUCTION l I (No septic system permitted it public sewer is available within 200 feet.) ti Installation will serve: Residence— Commercial Other Number of living units: Number 91 bedrooms Character of soil to a depth of 3 feet: Water table depth SEPTIC TANK D Type/Mfg Capacity No. Compartments PKG. TREATMENT PLT. ❑ Method of Disposal Distance to nearest: Well Foundation Property Line ,t 4 LEACHING LINE Cl No. & Length of lines Total length/size `+- `r' FILTER BED ❑ Distance to nearest: Well Foundation Property Line ;,F SEEPAGE PITS IJ Depth Size Number SUMPS Ll Distance to nearest: Well Foundation Property Line' DISPOSAL PONDS 0 r :: .p: F, I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin county ordinances, state laws, and rules and regulations of the San Joaquin County III 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 employ any person in such manner as to become subject to workman's compensation laws of California." Contractor's hiring or sub-contracting signature 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- tion laws of California." �= The applicant must call for all required inspections. Complete drawing on r arse sid . Signed x Hennings Bros. By rifle: Date: 8-24-93 f FOR DEPAR ENT USE ONLY II Application Accepted by - Date Area, Pit ofiG11 napection byIt h Date Final Inspection by 14 1 Date i ,.,,rout r f r' Additional Comments: �`�/T Applicant - Return all co es to: _Jo n County Public Health Services £nvirtal Health Permit/Services 445 N San Joaquin, P O Box 2009, Stkn, CA 95201 NFO AMOUNT DUE AMOUNT REMITTED CASH RECEIVED BY DATE PERMIT'NO. F9 FECK I