10724 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No. rJ...�sZ--�� (Complete in Duplicate) � /" Date issued ----7V6- ----- ---�__ Application is hereby made to the San Joaquin Local Health District for a permit to construct and -install the work herein described. This application is made in compliance with County Ordinance No. 549. arve t s Tire Co. Hwy 99 & Cherokee Lane JOB ADDRESS AND LOCATION----__--- y - ------------------------------------- ----------------- ---- �2—OCo�-- She and & Green '� w Owner's Name - - -- --------------------------------------------------------------------------- Phone Address------_----------------------American Trust Bldg. Stockton ---- r------•---•----- --------------------------------------------------- •--------------------- --------------------------------- Tnc -HO b-9b07 Contractor's Name--------------------------------------------------------------------------------------------•----------------------------- ---------- ------- Phone----------------------------------- Installation will serve: Residence ❑ Apartment House ❑ Commercial R9 Trailer CourtMotel E] Other E]2 toile-us acreage Number of living units: _____._ Number of bedrooms -------- Number of baths -------- of size _________________________ __ Water Supply: Public system ❑ Community system'❑".Private`[? Depth to Water Table __50sft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ® Hardpan ❑ Previous Application Made: Yes ❑ No ® New Construction: Yes ❑ No ® FHA/VA: Yes ❑ - No IF] TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or'cesspool permitted if public sewer is availa6le within 200 feet.) Septic Tank: Distance from nearest well -00'---__Distance from foundation__.__l��__._ _.Material_.-CC___briCk - - �] No. of compartments----------------- --------Size----56x, 6----I----------Liquid depth-----70"-------------Capacity----W_0...gall Disposal Field: Distance from neares well. _-.._.Distance from foundation-___i_______ Distance to nearest 112t 100� 20� ----- e---100'--- IN Number of lines______ ________---------------Length of each line------____,_5- -h._______.Width of trench__-______ t I th Type of filter material elL__.l��k:___D sten effrotmrfoundation_4��:..:.___Tosalnce gohnearest 15101' __-lOO;• Seepage Pit: Distance to nee el,1fn Number of pits----------------------Lining material __rook Size: Diameter_--------------------Depth--.------------------------ i Cesspool: Distance from nearest well-----------------Distance from foundation-_ -_._____.__.____.Lining material-_.____-___________.____.________-1 ❑ Size: Diameter------------------------- ------Depth-----------------------------------------------------Liquid Capacity----------------------------9a '+l Privy. Distance from nearest well------------------------------------------------- from nearest buildingI f ❑ Distance to nearest lot line.' - ---------------- ------------ -- -----------------•--•--I----------------------- -- ------------------------------------- -t� Remodeling and/or repairing (descri4�e}:--��_ _p__ c__ ailk-_t_o_-_Sei'Ve-_-b._ m I.O e93- I� -------------------------•----------------------------------•=-------------- -----•----------------------•--------------------------------------------------------------•----------------•--•----•-----•---•------------ ------------------------------------------------------------------'-=-------------•-----------=----------------------•-------------- -------------------------------------------------------------------------------------- -------•--------------------------------------------------------------•----------------------------------------------------' I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. (Signed)___ -----------------------------Parrish & 5€3 15 {Owner and/or Contractor) --- i -- By:--------------- --------------------------------------------------------------------------(Title)--------Est. ---•-•------------------------------------- (Plot -------------------- -----------(Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). .. ! FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-----. -------------- -------------- ---------------------------------------- DATE.--------- �------------------ REVIEWEDBY-------------------------------------------------- --------------- ----------------------------------------------------------- DATE------------- ---------------------•-------------------- BUILDINGPERMIT ISSUED---------------------------------------•-------------------------------------------------------------- DATE------------------------------------------------------------- Alterationsand/or recommendations----------------------------------------------- ------------------------------------------------------------------------ ------------------------ ------------ ---•------------------------------------------•----------- -----•--- ---------r-------------------------- r -----:----------------------------------------- -----------------------------------------------------------------------------------7 I ------------------------------------------------------------• -•----------------- --- ------------------------------------------------------ -- ------------------------------------------------------------ --- - , - - FINAL INSPECTI DN BY-; 1'/ -- ------ Date-------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-11--20 Revisea 1-57 F.P.CO.