21957 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: ----- ------ - APPLICATION FOR SANITATION PERMIT hermit No. � - ---_-- (Complete in Duplicate) Date Issued -_� -•=�� ------ " __ This Permit Expires 1 Year From Date Issue , Application is hereby made to the San Joaquin Local Health District for a per�to cit�ructE This an stael t fJ,k herein descril7e d. Ts application is made in compliance with County Ordinance No. 549. f [ ,j. ----- -------- JOB ADDRESS AND LOCATION___. {}L-- - �y �q � �f Phone-------- ' Owner's Name------ f� L'_ ------W-6-hao-n-""-------- Address x t Contractor's Name___ __j e----�� Motel ❑ Other ❑ � Installation will serve: Residence TK Apartment House Commercial ❑ Trailer Court C] t � �t. Number of living units: __!_-_-_ Numbeer of b9d'rooms _ -- Number of baths j---- Lot size _ __ e�Q ft. Water Supply: Public system F-1ComAunity system El Private X Depth to Water Table Clay ❑ Adobe� Hardpan ❑ Character of soil to a depth of 3 feet: Sand E] Gravel [I Sandy Loam ❑ Clay Loam ❑ Previous Application Made: ,(If yes date.__.- .....) No ❑ New Construction: Yes* No FHA/VA: Yes E] No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Se ti1�Ta Distance from nearest well ___.-----------Distance from foundation--------------------Material _._._____.__...______._-.---------------------- No. of compartments Size-------------------------------Liquid de�h--------- ----------- Capacity------------ --•---- -� Ile �-------- --/AN _-______.Distance to nearest lot line_ Dis sal 'N Distance from nearest well. _-.Q...._-_Distance from foundationWidth of trench_._ t �f 4�� Number of lines --- _Length of each line____-_ __.. - �'-�- � f� - --------- i� � � _De th of filter material___._f. ___ Total- length-------------------------------•--------- Type of filter materi l�' p ;� . Q ,Distance to nearest lot line ._.��--.-�� ----- ii nn Seepage Pit: Distance to nearest_well_._f_________________Distance from foundation__- Deptn___.__1!� • Size: Diameter._.^_ - Number of pits._._-----------------Lining material___�_�B - � �....� Cesspool: Distance from nea est,well_J a._...--_..__Distance fro oundation-_- .__-__-._!---..Lining material_____-----------------_-------------- Cesspool: ______._ _-. Depth ---------------------- o ." ----Liquid Capacity----------------------------gals,i�u ❑ Size: Diameter-------------I---------°= - ------- - - - ,, 1 Privy: Distance from nearest well__-r-T - .- __________________________Distance from nearest building-i5------------------------------------"" _y I ❑ Distance to nearest lot line " t ------ --------------------------- --•------------ ----------------- Remodeling and/or. repairing (describe):_- _.-_ }I t C ._ ---I-e_ Y --------------------------------------------------------- -- r i _ _ ---- -------------------------------------------------s__________y_ .a. I hereby certify that I have prepared th;s..application and that the work will be done in accordance with San Joaquin County ordinances, State laws, anOules and regulaftons of the;San. Joaquin Local Health District, i ✓✓nye ( � „;�•' w„ ��Contr""actor) ....- (Signed)-------------------""- ""ay---&--- 1d----------; --- SEPTIC TANK SERVICE Title y:-----2-9d-5�:miner-ft-- - F1Cr:0=:3":;r�--" " bu4ildings, +c., can be placed on reverse side). (Plot plan, showing size of lot, location of system in relation to ells, FOR DEPARTMENT USE ONLY q DATE_X - 14-{ ------------------- APPLICATION ACCEPTED BY__ ----"------ ------ DATE_ -- "------"-----•------ -- -------------- --------"-- REVIEWED BY ------------------------ ----------------------------------------------------- ---------- --------- DATE. BUILDING PERMIT ISSUED_____________________ ----------- Alterations and/or recommendatio :_____.. ------------------- -----------•------------------------------------ ,.b,, t= ------- - ------------------------------------------- �� ------- ------ ------------ ------------ -------- -------------- ----------- FINAL INSPECTION BY:_ SAN JOAQUIN LOCAL HEALTH DISTRICT 1401 E.Haxelion Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California