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68-411
EnvironmentalHealth
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FILBERT
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1909
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4200/4300 - Liquid Waste/Water Well Permits
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68-411
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Entry Properties
Last modified
2/7/2019 10:30:30 PM
Creation date
12/5/2017 2:59:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
68-411
STREET_NUMBER
1909
Direction
N
STREET_NAME
FILBERT
City
STOCKTON
SITE_LOCATION
1909 N FILBERT
RECEIVED_DATE
05/09/1968
P_LOCATION
J WHITE
Supplemental fields
FilePath
\MIGRATIONS\F\FILBERT\1909\68-411.PDF
QuestysFileName
68-411
QuestysRecordID
1765667
QuestysRecordType
12
Tags
EHD - Public
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FOR OFFICE USE: 1 <br /> ---- --------- Permit No. <br /> --- --- ------ ----� - APPLICATION 1=0R SANITATION PERMIT <br /> ----------- - -------- ...-- - ------ _ <br /> --- ---------------- (Complefe-in Duplicate) Date Issued ._-_ - _ <br /> - ---------- ------------------ <br /> ----------- This Permit Expires 1 Year From Date Issued <br /> Application is hereby made Ik o the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinanc7 No. 549_ <br /> I� --------•---------------- <br /> JOB ADDRESS AND LOCA ION.._._�9�-�.._l_!!1-�.____A&Ztf-" -. <br /> Owner's Name--,L -,Vo <br /> -- ---- •--®�- •-----------------•---------------- -- - ------------------------------- <br /> Phone---------------- ------------------- <br /> Address �/r �a✓� ------- <br /> _ ft <br /> ,tc! --- Phone-------------------------•-•------- <br /> Contractor s Name ---v <br /> installation will serve: Residence [I-Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ .Other ❑ <br /> Number of living units'�I: _- .-�- Number of bedrooms -�____ Number of baths .... Lot size _-_ _S__-x- --'------------------------------ <br /> Water Supply: Public syst��1r1 ©—Community system [-IPrivate F1 Depth to Water Table 60- ft <br /> Character of soil to a depth of 3 feet- Sand E] Gravel F1 Sandy Loam [j Clay Loam ❑ Clay ❑ Adobe Hardpan ❑ <br /> I <br /> Previous Application Made:: (If yes,date_-------- -------- ) No M-11, New Construction-. Yes ❑ No 2r FHA/VA: Yes ❑ No [5' <br /> TYPE OF INSTALLATION SAND SPECIFICATIONS:. <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> 1 <br /> t Septic ank:' Distance) from nearest well__--------------Distance from foundation--------------------Material ___-_____________-___-_---___-_________----___. <br /> � No. of 'compartments---- ---------- ------Size-----_-----=------ -------•---Liquid depth.-------- - --- --------Capacity---------- i---- <br /> Dis osal Feld: Distance from nearest well-~"�-____---.-Distance from foundation__f!1__-_-_____-_.Distance to nearest lot line.--`S-�_...__ <br /> P 'l ` Length of each line__gd-F-----------------Width of trench--- _ `�______________-_ <br /> Numberlsnf lines-=----�------------------------- <br /> Type of filter ma;erial-___.Jta-�cf ----Depth of filter material___��' "_____.Total length-------r�4_____---------------------- <br /> Seepage Pit: Distance to nearest well.._-__.--. _---______Distance from foundation___________________ Distance to nearest lot line.---------------- <br /> ❑ Number) of pits--- ----------- -------Lining material-------------- ------- Size: Diameter-------- -----Depth--------------------------------- <br /> ij. <br /> Cesspool: Distance from nearest well -__-_...___-__Distance from foundation_________________ __Lining material____-.-.-.-.--__.-_-___-._.__._.___- <br /> ❑ -Li Liquid Capacity-... gals <br /> Sino: Diameter- f Depth q P Y <br /> y rest•well_---------_--- ----- =...'-Distance from nearest building----------------- -------------------- - <br /> El Priv Distance to neareDistance from st lot line ..-.-- ----•---------- - ------------- ------------------------ --------------- <br /> I <br /> ----------- <br /> Remodeling and/or repairing (describe):_ ------ <br /> - - <br /> 4 4 <br /> F <br /> ____________________________________ <br /> I! -------- - - - <br /> 1 hereby certify that I]have prepared this application and that fhe work will be done in accordance with San Joaquin County <br /> ordinances, State laws, 'and rules a regulations of,fhe San Joaquin Loc I Health District. <br /> 1 1I _---- _------------------------(Owner and/or Contractor)- _ ---------- - <br /> (Signed)---------- , <br /> Plot plan, showing size sof lot, location of system in relation to wells; - - ___n ___.. Title - ---------- --- <br /> s •------------------- - i __ _ (Title)}--------------_-- .-.-.. <br /> ------- <br /> (Plot buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> :11 <br /> APPLICATION ACCEPTED BY...1!-V-� ----------------VD'___-_._-- <br /> �k-y------ --- --------------------------- <br /> ------- DATE----- J� & ------------------------------ <br /> _ - <br /> REVIEWEDBY--------------- ----------- ------- - ---_--------- ------------------------------------------ ----------------------- DATE----------------------- <br /> BUILDINGPERMIT ISSUED-------- 1------- --- --------- DATE--------- ------------------------- ------------------------- <br /> Alterations and/or recom i1endations:----- ------------------- -J1_----------- ------ --------• -------------------------------•--- <br /> .. ------ -J1I_------------------------------------------------------------------------------------------------------------------ <br /> - - ---- <br /> ---------- <br /> ------------ <br /> II. -------------------------------•------ -------------------------------- <br /> F ----------------------------------------- <br /> k---f------ ...................... --------- -------------------------------I— --------- ------------- ------------------------ <br /> ----------- ----------- ---------- - <br /> t !- <br /> -------------- <br /> Dote- LJ �` b <br /> FINAL INSPECTION IBY: `- <br /> 1 SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E.Hasetton Avop. 300 West Oak Street 124 Sycamore Street 205 West 9th Street <br /> Stockton,Californiap Lodi. California Manteca,California Tracy,California <br /> E.H.9 2M 1-67 Vanguard Press <br /> i <br />
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