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69-989
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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FILBERT
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1550
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4200/4300 - Liquid Waste/Water Well Permits
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69-989
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Entry Properties
Last modified
2/16/2019 10:22:47 PM
Creation date
12/5/2017 2:58:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
69-989
STREET_NUMBER
1550
Direction
N
STREET_NAME
FILBERT
City
STOCKTON
SITE_LOCATION
1550 N FILBERT
RECEIVED_DATE
12/02/1969
P_LOCATION
HOLSTE
Supplemental fields
FilePath
\MIGRATIONS\F\FILBERT\1550\69-989.PDF
QuestysFileName
69-989
QuestysRecordID
1766146
QuestysRecordType
12
Tags
EHD - Public
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LFORICE USE: ppp!(CATION FOR SANITATIION PERMITpermit No-- j `' (Complete in Triplicate) <br /> Dateissued ==` ---r--- ----- 3 ----- p <br /> This Permit Expires 1 Year From Date issued y <br /> Y !rein <br /> county Ordinance permit <br /> 'and-rex'sting Rules and Regulations•ol <br /> Application is hereb made to the San Joaquin eavlvi}heCoupytrict for a permit to construct and install the work he <br /> described. This application is made �n compliance ol ej / <br /> C ' - _CENSUS TRACT J�--- ----{ ----- <br /> JOB ADDRESS/LOCATION . �� -- <br /> Phone / <br /> ---- ------------ <br /> ------------------------------- <br /> Owner's - <br /> Name -rt 1 1 ,�,- / -q <br /> Address - ------ ---------- - J " � / -i.Li ense #/ Z Phoney . <br /> r --- _ ---- <br /> Contractor's Name _---.---- - - <br /> �.....- <br /> � <br /> I Installation will serve: Residence Apartment House❑ Commercial Trailer Court 'C] <br /> Motel ❑Other ---- ------------- - ------------ <br /> 1 u'------ ------- <br /> nits <br /> ------ -� <br /> Garbage Grinder-cJ--- Lot Size . _.__.____ <br /> Number of living units__.. Number of Broom Private ❑ <br /> - ------------------- <br /> Water supply: Public System a�d name .__ -t" �---------- <br /> CI Peat❑ Sandy=Loam ❑ Clay Loam:❑ <br /> �i Silt❑ AY ❑ <br /> Character of soil to a depth of 3 feet: Sand❑ �� , <br /> Hardpan'❑ VAdobe' iTl Material ............. If es,type <br /> (Plot pion, showing size of lot location of system in relation to wells, buildings, etc. must be placed on reverseside.j <br /> { e t it ermined if public sewer is available within 200 feet] <br /> g <br /> NEW INSTALLATION: {No septic tank or seepage.�p P Liquid Depth .............. E <br /> PACKAGE TREATMENT [ ] SEPTIC TANK'[ ] Size------------------=----------------- a p <br /> No. Compartments <br /> fft ------- <br /> Capacity ---- Type ---------------I---- Material--------------------I - . <br /> Pro - <br /> Line ------------ -- -- <br /> l <br /> Distance-to-nearest:.�Well, -k--= Foundation _---.------- p <br /> LEACHING LINE [ ] No. of Lines ------ - ------- ---- Length of each line--------------------- --- <br /> Total Length <br /> 4 <br /> 'D' Box __ --_--- ype Filter Material --------------`-----Depth Filter ,-Material <br /> Property dine <br /> Distance to nearest: Well ----------------- Foundation -- , <br /> ry t --__.--_. Rock Filled Yes ❑ No I� <br /> j ..� Number - <br /> SEEPAGE PIT L 1 Depth ------------ <br /> .-Rock <br /> ---------- Diame#erg <br /> t _ i <br /> Water Table Depth Rock Size ____'-------------- - <br /> - Vie . <br /> Distance t nearest: Wel! ------------------ -------------'-----Foundation -------------------- Prop. Line .------•----`--- <br /> aI I } Dater------- ---) <br /> (REPAIR/ADDITION(Prev. Sanitation <br /> Permit# -•------,------------------------------ i <br /> Septic Tank {specify Requiremen#s) ----------.- <br /> r, ----- �. = _ ---------- <br /> me <br /> ----- <br /> l/ r <br /> Disposal Field [Specify Requirements) ------------ <br /> ----------- <br /> -------------------- <br /> I_/ .�, - b - ---- -+ -------- ---------- -II <br /> -� (A <br /> r <br /> - ----- -- + .. - {µ with San JJ <br /> - - . <br /> --- ---------------`--ce-------- <br /> -------------------------------------------------- <br /> (Draw"ex'Visting and require�d additio on reverse side) oaquin <br /> in <br /> I hereby certify that I have preparied this >pplication ulatiat►stoF the San Joaquin Local hlat the ark will be oHeal h District. Home owner or licen� <br /> County Ordinances, State Laws, and Rules and 9 ✓ <br /> i' �/ d <br /> sed agents signature certifies the following: erson in such manner <br /> that in the erformanceiof'the work for which this permit is issued, I' shell not employ any p <br /> I certify p /f <br /> as to becomesubject to Workman �Compen�tinn law�af California." ill <br /> is .� Owner <br /> -------- <br /> Signed ----� <br /> �,� <br /> s - tl - ----- ------ <br /> � ;Tie <br /> - ----- <br /> {l'flother t owwner) <br /> O EPAIRTMENT USE ONLY 3 <br /> r-- �' cy <br /> - _ ;i <br /> APPLICATION ACCEPTED BY ------- - --- -- _a------DATE ------------- <br /> -- -- ------------------------ -------------------------- <br /> BUILDING PERMIT�VSSEJED . ----- -- - - ------ ------ -=------------------------- - <br /> ADDITIONAL"COMN4 TS ?, --------------------------------------------------------------------------------------------------------------- <br /> ----------------------- ---- ----------- <br /> --- - ------ -------------------7 - <br /> - - - ------:�--^-;---- -- -- -- --- - --- - Date ----- ------- --- - - -- .. ---- <br /> Fina! Inspection b ' II `e <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT , <br /> E. H. 9 1-'68 Rev. 5M. __' <br />
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