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69-965
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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69-965
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Entry Properties
Last modified
2/16/2019 11:10:54 PM
Creation date
12/2/2017 12:40:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
69-965
STREET_NUMBER
428
Direction
S
STREET_NAME
GERTRUDE
City
STOCKTON
SITE_LOCATION
428 S GERTRUDE
RECEIVED_DATE
11/24/1969
P_LOCATION
BILL FITCH
Supplemental fields
FilePath
\MIGRATIONS\G\GERTRUDE\428\69-965.PDF
QuestysFileName
69-965
QuestysRecordID
1784756
QuestysRecordType
12
Tags
EHD - Public
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- - ~^~" OFFICE'~^ ~ APPLICATION FOR SANITATION PERMIT <br /> ��~� Permit No. <br /> ''�777-�~� ' (�wm�Ue�,�n Try�lCc�+w0 ' <br /> ` ~~ Date |uoue6 .�������J8�' <br /> This.PermitExpires I Year From Date Issued � <br /> Application is <br /> h 6 the San Joaquin Local HealthDistrict for o |t to construct and install the work herein <br /> ~'~~� made x» <br /> described. This opp|/oot|on`|s made in compliance with County Ordinance No. 549 and existing Ro|oo and RaQu|pt\mnn' <br /> J <br /> Phone 7V <br /> --V- 7., r-'N.41---------- <br /> Installation will serve. �,Resiclence El Apartment House,E] Commercial�[D]Traillr Court [3 <br /> Number of living units-----I------ Numb&ro'f_-bedrooms =/____GAaage Grinder -------- Lot Size ------- <br /> Character of soil to a depth of 3 feet: Sand'El Silt-E] Cllay El \Peat[] Sandy Loam <br /> (Plot plan, showing i f |n* location f system in relation to wells, buildings, etc must be pl ced on reverse side. <br /> NEW INSTALLATION: (N� septic tank or seepage pit permitted if p6blic sewer is av.ailable within 200 feetA <br />� -~tance-- - nearest:— Well' t � �� = <br /> of Lines <br /> LEACHING LINE <br /> �� ]� <br />| ") Box ----------- 'xr~ Filter^ '`~'~'~'Length of---'-�--,.--,- . -'` ' * <br /> ^ , <br /> Distance to nearest: Well Line -----__I—-------- <br /> SEEPAGE n/ Depth- Diameter Number illed Yes No <br />� u/ <br />� <br />�� -------------------- <br /> /Disposal Field (Specify 1 <br /> - -� <br /> I hereby certify that I have, preparedithis application and that the work will be don <br /> County Ordinances, State Laws, &a R'dies and Regulations of the Son Joaquin Local Health District. Home owner or licen- <br /> sed agents signature certifies the following: <br /> i <br /> as to become subject" to Workman's -~-p- <br /> nsation laws of California." <br /> / ' <br /> � <br /> (if oi7h-- t -owner) FOR DEPARTMENT USE ONLY <br /> 1 � <br /> / p.pruCa//um ACCEPTED [BY fs-°' ^` ^°` <br /> � "°°'''°'^�^ �~'~`'^'`' � ------ <br /> ------------ <br /> �. <br /> `_.�___��-____—.�`.---.-�.��—o+'_. ^"----'--'—'^~--'---v~-'--'v--------- « - � <br /> _---.�---------- <br /> ------------ / <br /> �--_'_--__---__---__---._--'—.—.------_----.—.--_-� . <br /> __by <br /> .----.--_.—_.-���- <br /> 'F|no| |nopec |un6y. - .. ��^ --------����-----DoYe -�^."�.��`��'�@�.. <br /> 34N JDAQU|N LOCAL HEALTH D|5TR.[J <br /> � <br /> EM. 9 l''b8Rev. 6hA . <br /> ` - , <br />
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