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19537
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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19537
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Entry Properties
Last modified
11/19/2024 1:52:39 PM
Creation date
12/3/2017 4:17:52 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
19537
STREET_NAME
STATE ROUTE 99
City
MANTECA
SITE_LOCATION
W/S HWY 99
RECEIVED_DATE
09/13/1965
P_LOCATION
MICHAEL ZOTTARELLI
Supplemental fields
FilePath
\MIGRATIONS\N\99 (HWY99)\0\19537.PDF
QuestysFileName
19537
QuestysRecordID
1877473
QuestysRecordType
12
Tags
EHD - Public
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FOR OFFICE USE: <br /> ------------- ----- ---- ------------------ Permit No. 1..fe� F-� <br /> -------- - APPLICATION FOR SANITATION PERMIT <br />- - <br /> -------------------------------------------------------- <br /> (Complete in Duplicate) Date Issued <br /> This Permit Expires 1 Year From Date issued <br /> Application is hereby made to the San Joaquin Local Healfh District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> !_x __11 - 134iA4 <br /> JOB �AN?D LOCATII <br /> �n ----- -------- Phone------------------------------------ <br /> Owner's Name-------------1�--L � .T --- T <br /> Address----------- -------�'�� ' ~�`------i3 ax.-------- ------------- - -------------------------------------- ----••------- <br /> ctor's Name---------- <br /> ____ --------------------------------------- <br /> Phone------------.-.___.___ - <br /> Contra �nR <br /> Installation will serve: Residence ❑ Apartment House ❑ Commercial ®Trailer Court ❑ Motel ❑ Other ❑ . Hol . <br /> -- � --------------- <br /> Number of living units: ---- Number of bedrooms --__--.- Number of baths _-�__ Lot size ---/-._. "C�`1 I Ff <br /> Water Supply: Public system ❑ Community system ❑ Private p/Depth to Water Table <br /> Character of soil to a depth of 3 feet: Sand E�`Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ❑ Hardpan ❑ <br /> Previous Application Made: 11f yes,date--------------------) No © New Construction: Yes ©-140 ❑ FHA/VA: Yes ❑ No [ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) 1 <br /> _-_-Distance from foundation--.--/_0------.Material--- �- - ---------- <br /> Septic Tank: Distance from nearest well--. <br /> No. of compartments---------r�-_'------- Size--,3..X - ---Liquid depth----I --------Capacity----I - ----- <br /> Disposal Field: Distance from nearest well-- -�Q_ -� <br /> -Distance from foundation- 0----------Distance to nearest lot line- _.__--__--- <br /> ❑� Number of lines------- 1-------------------Length of each line------ r'--.--...._--.Width of trench------ /------------ <br /> Type of filter material---- !qO1�__Depth of filter material ��---..---- otal length-------------- ------------------ <br /> Seepage Pit: Distance to nearest well--------------_------Distance from foundation----_--------------.Distance to nearest lot line--.-------------- <br /> F1 ----------- <br /> - -- <br /> Number of pits----------------------Lining material-----------------------Size- Diameter.----------------------Dept --------------------------------- <br /> Cesspool: <br /> _..____--__ -- <br /> Cesspool: Distance from nearest well-----------------Distance from foundat'on--_--------------- Lining material----..-----.---------_-------- a4s. <br /> ❑ Size: Diameter--------- --------------- --Depth--------- ------------------------- ----------------Liquid Capacity-- ------------------- ----9 <br /> ---------- <br /> Priv Distance from nearest well--------_---------------------------------------Distance from nearest building..---.-.------__---------_--.._---------. <br /> Privy:. <br /> --------------- ---- --------------------- <br /> Distance to nearest lot ine._--------------------- - --------------------------------'- v <br /> Remodeling and/or repairing (describe :--------------------------------- ----------------------------------------••-- <br /> ---------------------------------------------------------- <br /> ------------------------------ ---- ----------------- <br /> ---------------------------- <br /> --------------------------------------------------------------------------------------------------------------------------- <br /> - - - <br /> 1 hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin Counfy <br /> ordinances, Sipte laws,�ibd rules and regulations of the San Joaquin Local Health District. <br /> ` ------------- -- <br /> (Signed)---- <br /> —r7 <br /> - <br /> ,, �,� (Owner and/or Contractor) <br /> "r.�' a - <br /> Si ned - _ <br /> I Br-------•------------ ------------------------------------------------------ <br /> -� -------- --------(Title)---------- --------------- - - - --- ------ <br /> - <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> I FOR DEPARTMENT USE ONLY <br /> DATE------- g� z -------------------------- <br /> DATE <br /> S - <br /> APPLICATION ACCEPTED BY-.- ---..I--c-R` ------------ ---------- ---------------------------------------------- / -- <br /> REVIEWED BY-------------------------------------------- -------------------------------------------------------------------------------- <br /> DATE---------•-•--------- - --- -----------•------------------ <br /> BUILDING PERMIT ISSUED------------------------------------------- . <br /> ---------------------------------------------- <br /> DATE------------------------------------------------------------ <br /> Alterations and/or recommendations:-------------------------------------------------------------------------------- <br /> -------- <br /> --- ----------- <br /> ------------ <br /> /Jy -----•----------------------------------------------- <br /> .......... -------- 6 <br /> FINAL INSPECTION—B _: ---- -- - - <br /> ---�7 Date--- ----� 6.5 <br /> S <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E.Hoxetion Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street <br /> Stockton,California <br /> Lodi,California Manteca,California Tracy,California <br />
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