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20878
EnvironmentalHealth
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FILBERT
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1961
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4200/4300 - Liquid Waste/Water Well Permits
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20878
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Entry Properties
Last modified
1/2/2019 10:06:02 PM
Creation date
12/5/2017 3:00:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
20878
STREET_NUMBER
1961
Direction
N
STREET_NAME
FILBERT
STREET_TYPE
ST
City
STOCKTON
APN
11914057
SITE_LOCATION
1961 N FILBERT ST
RECEIVED_DATE
07/22/1966
P_LOCATION
GLEN MCGILL
Supplemental fields
FilePath
\MIGRATIONS\F\FILBERT\1961\20878.PDF
QuestysFileName
20878
QuestysRecordID
1766305
QuestysRecordType
12
Tags
EHD - Public
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FOR OFFICE USE: <br /> --------- ---- -•---- ----- <br /> ------------ __ M t Permit No. r <br /> �- APPLICATION FOR SANITATION PERMIT <br /> ------------- --------------------------------- <br /> ------- ---------------------------- {Complete in Duplicated -off _ G <br /> - --- ----- ---- Date Issued ---�"=�------- <br /> ------- ------ This Permit Expires 1 Year From Date Issued <br /> Application is hereby made to 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 Ordinance No. 549. IYD-5 "7 <br /> JOB ADDRESS A D LOCATIONI- --- <br /> Phone----- <br /> Owner's Nam <br /> Address-------- -y�� ---- ------- -------------------------- ---------------- --- <br /> Contractor's Name------ i Phone----------------------------------- <br /> Installation will serve: Residence Apartment House ❑ Commercial E] Trailer Court ❑ Motel El Other [I <br /> Number of baths - _-._�-V----1 Ak--------------------•------------- <br /> Number of living units: _1---- Number of bedrooms -.2 � - <br /> Lot size <br /> Water Supply: Public system Community system ❑ Private ❑ Depth to Water Table ft. <br /> Character of soil to a depth of 3 feet: Sand ❑. Gravel.❑ S ndy Loam Ll Clay Loam El Clay E] Adobe-Hardpan ❑ <br /> Previous Application Made: (If yes,date-_--- <br /> ------) No New Construction: Yes [:] No � 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.) <br /> I <br /> Septi an'k Distance from nearest well--_-------------Distance from foundation-_-----_-_---. --Material-----------------_..----_------ .---------_-. I I <br /> �� � No. of compartments------ -------------------Size----------------------------:---Liquid depth - Capacity - <br /> t Disposal :� Distance from nearest well--------------- -Distance from foundation-------------------.Distance to nearest lot line--------------- <br /> 6' <br /> ❑�� /Number of lines-----------------------------------Length of each line`--------- Width of trench. <br /> Type of filter material-------------------- ---Depth of filter material----------------------Total length------------------------------------ ---- <br /> �� Distance to nearest lot line__-_-_----. r <br /> Seepage Pit / Distance to nearest well-_�-------------Distance ram foundation---.---------------- <br /> mf size: Diameter_ <br /> Number of pits-. ----------------Lining materia{ - Depth 1 <br /> Cesspool: Distance from nearest well-----------------Distance from fc.undation--------------------Lining material---------------- <br /> ❑ Size: Diameter-,-----------------------------------Depth----------------------------------- - --------------Liquid Capacity------------•---------------gals. <br /> Privy: Distance from;nearest,well-----_.--- .,:------------------------------ ---Distance from nearest building-------------.--------------------------- <br /> a - <br /> ❑ ----------------------------- -------------- <br /> Distance to nearest lot line------------------------------- -------------------------------- <br /> - ------------------------- <br /> ' � ---------------- r <br /> Remodeling and/or repairing {describe):----------------- ------------------------------ <br /> ----------------------------------------------------------- <br /> - t <br /> ---------------------------------------- <br /> -------- ----- <br /> 1 hereby certify t at I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State 1 rules d egulati sof the San Joaquin Local Health District. <br /> _ � - (Owner and/or Contractor <br /> (Signed) ------------------------------- --------- ------------------------ <br /> 1 <br /> Title <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> j FOR DEPARTMENT USE ONLY <br /> It APPLICATION ACCEPTED BY-.--- --- ----------------- D) -/Ill --��------- <br /> I ---- <br /> 10 <br /> REVIEWED BY--------•------------------------=-- ----- ---- ------------------------------------------------------------•- <br /> ------ DATE----- -- ----------------------------------------------------- <br /> -- <br /> BUILDING PERMIT ISSUED----- `------------ -4; <br /> -- --- ------ <br /> ------- ------ --------------- <br /> Alterations and/or recommendations:__..--..-�..--._--.11---------------- -4- - --- <br /> ---------- ------------- ---------- <br /> ..'---- -- --- --------- .k----------------------------•- --- -" <br /> = Date---- - ----------- �- -----------------------�- <br /> FINAL INSPECTION BY:... ----- -- --- - - - -- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E.Haselton Ave. j 300 West Oak Street 124 sycamore street 205 West 9th Street <br /> I <br /> Stockton,California <br /> Lodi,California Manteca,California Tracy,California <br /> $7.P.cn. <br />
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