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SU0002304
Environmental Health - Public
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EHD Program Facility Records by Street Name
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N
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99 (STATE ROUTE 99)
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18621
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2600 - Land Use Program
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UP-96-05
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SU0002304
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Entry Properties
Last modified
11/19/2024 1:58:42 PM
Creation date
9/8/2019 12:54:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0002304
PE
2626
FACILITY_NAME
UP-96-05
STREET_NUMBER
18621
Direction
N
STREET_NAME
STATE ROUTE 99
City
ACAMPO
ENTERED_DATE
10/26/2001 12:00:00 AM
SITE_LOCATION
18621 N HWY 99
QC Status
Approved
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SJGOV\sballwahn
Supplemental fields
FilePath
\MIGRATIONS\N\HWY 99\18621\UP-96-05\SU0002304\EH TRACK LOG.PDF
Tags
EHD - Public
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1 <br /> 1"I <br /> PYAN <br /> APPLICATION FOR WELUPUMP PERMIT <br /> JOENVIRO COUNTY L HEALTH DIV H SERVICES `�/ <br /> id <br /> 304 EAST WEBER AVENUE, STOCKTON, CA 95202 <br /> (209) 468-3420 A� <br /> XOR-REFUROARLE PERMIT EXPIRES 1 YEAR FROM DATE ISSUED <br /> IC/Rg1ElS M Trylk/RI <br /> APPLICATION IS HERE SY MADE TO THE SAN JOAWN COUNTY FOR A MEANT TO CONSTRUCT ANDpR INSTALL THE MWD MMUD.TIRE APPLICATMN 10 MADE IN COMPUANCE All <br /> "AWN COUNTY DEvELOPMEM TFTLE.CHAPTER 8-1115.3 AND THE/TANOAIO/OF SAN JOAWR/COUNTY PUBLIC HEALTH SERVICES,ENVNIDNMENTAL HEALTH DMSGN. <br /> Joe ADORSMRAPHI 18621 N. Hwy 99 CITY Lodi PARCEL ISSUANCE <br /> OWNER'/NAME Calvary Bible Church ADDRESS P.O.Box . 1503, Lodi,Ca PLIONEE <br /> cown,ACTORPurviance Drillers, Inc. ADIRES/ P.O. Box 64,Linaw 3779�4NEE887-3554 <br /> BOB CONTRACTOR ADDRESS LIC! PHONE E <br /> TYPE OF WELLIPVMP: EI NEW WELL ❑ IIEPLJICEMENT WELL ❑ MONNORIIID WELL 0 ❑ OTHER <br /> ❑ INSTALLATION ❑ WELL"STEM REPAIR ❑ CROSS{ONNECT REPAIR ❑ VAPOR EXTRACTION WELL E J <br /> Submer 0 N•...❑RTw N.P. 7 1 /2 DEPTH FVMPBE,1 30 ST. FIRSTWATERLEVEL O <br /> DYNE OF PUMP) <br /> ❑ OVTCF-SERVICE WELL ❑ nEOR1vBICAL WELL, ❑ BOR SORNO S <br /> ❑OEBTRUCTION: u <br /> INTENDED USE TYPE OF WFLL CONSTRUCTION OPECIFICATIONS A <br /> ❑ INDUSTRAL 13 OPEN BOTTOM DIA.OF WELL EXCAVATION 14 3/4 DIA.OF CONOUCTOR CASINO n/ A <br /> ❑1DOMEST,CIRIVATE ❑ORAVEL PACKISIZE TYPE OF CASINORTEEUPYC steel DIA.OF WELLCARPO 8 5/8 D <br /> 19PUMNIMUMCNAL ❑URVEH DEPT"OF GROUT SEAL 2201 SPECIFKATION . 156 A <br /> ❑ IRtlOATIONIAO ❑OTHER GROUT SEAL NSTAIUD SY PDI ONOUT BRAND NAME E <br /> ❑ MOMTOFING OR1VT SEAL PUMPED: ®YM EINE CONCRETE PEDESTAL BY DRILLER:❑Y. ❑NS 5 <br /> AFFr1OX.DEPT" 300 LOCKING CHESTER SOXMOVE RPE 5 <br /> PROPOSED CONSTILICTNINI LUNO METHOD: MUD ROTARY X AIR ROTARY AUGER CABLE OTHER <br /> I HMSY CERIT"THAT I HAVE FREPAREO THIN APPLICATION AND THAT THE WORK WILL BE DONE N ACCORDANCE MAIN SAN JOAOUIN COUNTY ORDINANCES.STATE LAWS,ANO RULES ANO <br /> REOULAMNS OF THE SAN JOAOUIN COLNETY. HOME OWNER OR LKENSM AGENT'S SIGNATURE CERTIFIES THE FOLLOWING:•I CERTIFY THAT W THE PERFORMANCE OF THE WORK FOR WIRCN <br /> LRS PERMIT IS SOUEO,I SHALL HOT PERSONS SUSJECT TO WORKMAN'S COMPENSATION LAWS OF CALIFORNIA.- COMRACTOR'B HIRING OR BUB{ONTRACTNO BKNATURE 11MIFIES <br /> THE F CERTIFY tH N TI AWE OF TIRE WORK MR WHKH TRB PERMN IS ISSUED.1 RNALL EMPLOY PERSONS RUBJECT TO WORKMAN'S COMPENSATION LAWS OF <br /> C RN,A.• TIR CANT C 24 IN ADVANCE FOR ALL RESUMED IMSP(CTIONS AT 1.14p-1422. COMPLETE DRAWING AT LOWER AREA FROVIDM. <br /> B,P„•,X T,,,• Corporate Secretary o„7/13/99 <br /> PLOT RAN ON.I.0••kl S••I• le <br /> 1. NAMES OF STREETS OR ROADS NEAREST TO OR SOUNDING THE FROMITY. 4. LOCATION OF HOUSE SEWAGE DISPOSAL SYSTEM OR IYOMSED <br /> O. OUTLIER OF THE FAOnFITY.DIVIIG OIAIENSGNO AM NORTH DIRECTION. EXPANSION OF NWAUS DISPOSAL SYSTEMS. <br /> 3. DIMENSIONED OUTLINES AND LOCATION OF ALL EXISTING AND FRO OM S, LOCATION OF WELL•WITNIN RADGS OF ONE HUNDOM FIFTY R. <br /> STRUCTURES,INCLUDING COVETED AREAS SUCH AS PATGS.DI/VEWAYS,ANO WALKS, ON THE PROPERTY OR ADJOINDEO PROPERTY. <br /> PHASE 2 <br /> a <br /> �o K,K FUTURE f 7i <br /> OFFICES rp 5 <br /> EDUCATION <br /> 312,000 SF -_ LAIMI <br /> J 8100'0•• -3. <br /> _ 1 <br /> Dv <br /> 0 3/8” <br /> 2 c c <br /> 350' <br /> PHASE 1 <br /> WORSHIP e D <br /> EDUCAT'I N <br /> P 4 <br /> _.I J24,343 SF , .D UTl <br /> D .. <br /> D'• 98'0" D 197 56 <br /> SE <br /> B.I IJ0 <br /> '0.. 4 II � G F'. 22C <br /> � I <br /> SFJ 13 j B I -Awl TIP r <br /> OEPMiMdT US!ONLY <br /> AIPIkNbR A•E•PI•S Sr //I / O•I• / O <br /> 0'..' ►T �`:i(✓��!�Q G D.I.( 'J `�� n.ns lmoeeKlnn eY RAY <br /> �/ p I D.I. <br /> O,.R�slkn N.Fsl1s.Sr <br /> �•mm•.. Ili t <br /> G p 97-&a <br /> ACCOUNTINO ONLY: AIDS FACE <br /> IF CODES FEE INFO AMOUNT REMITTED CMCXSMASH RECEIVES By DATE PRIAITRDLVIOE"Eq <br /> � rh <br /> 3 y 2-a Y. I II qi Y> <br /> o y <br />
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