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SR0084632
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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SR0084632
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Entry Properties
Last modified
1/27/2022 8:50:02 AM
Creation date
1/27/2022 8:18:53 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0084632
PE
4222
STREET_NUMBER
16133
Direction
N
STREET_NAME
MOORE
STREET_TYPE
RD
City
LODI
Zip
95242
APN
02702016
ENTERED_DATE
12/20/2021 12:00:00 AM
SITE_LOCATION
16133 N MOORE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
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EHD - Public
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Site Address: 16133 Moore Rd, Lodi CA 95242 <br />Date: 12/27/2021 <br />PHOTO # 1 Percolation test. <br />UI�YfY YLYIILI I 'Lv, 111 l_UN �1frL1'11 <br />ENVIRONMENTAL t1EALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton. CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: wvvw.sigov.org/ehd <br />ADDRESS OR LOCATION: S1 Cro„p er _ Cm: <br />OWNER NAME: y- - i <br />- -- -- _DATE <br />APN: APPLICATION M: <br />SOIL TYPE. ___ <br />REMARKS: <br />Test Hole # 1 Ra Test Hole # 2 <br />Parcel Diameter: ;, in Depth. qI, in I Parcel: Diameter in De the - in <br />PERCOLATION RATE: 1(,,, - -minfir <br />RECOMMENDED SEPTIC AREA: <br />TEST PERFORMED BY: G . '/Y1-. i C <br />TEST CERTIFIED BY: <br />OBSERVED BY(REHS): �ttAL1SI.n (J� •n_ <br />44203 REV 7112106 <br />Francisco Garcia Ruiz, Environmental Health Specialist Trainee <br />PERCOLATION RATE: S- min/in <br />RECOMMENDED SEPTIC AREA: <br />Phone: ?.>a -�•1 s - i Date r <br />Phone: Date <br />Phone _jot J° 3Z Date—1z'1Z11 Z I — <br />PERC TEST RATE FOR',1 <br />Record ID: SR0084632 <br />Page 1 of 2 <br />
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