4682 - Laserfiche WebLink

Home Browse Search

ICA;&f _ n FOR SANITATION PERMIT" Permit No, 7` .-F (Complete in Duplicate) Date Issued -/ -/CJ."S� Application is hereby made to the )an aquin Local Health District fora per to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. ) JOB ADDRESS AND LOCATION_.____ S ----------------- ------ -----------------------•---------- + Owner's Name -.r . I Phone Address- - -- . ----- ----------------- ---------------------------------- ontractor's Name_____- Y' , Installation will serve: Residence Apartment House ❑ Commercial Phone___________________________________ ;,At ❑ Trailer Court ❑ Motel ❑ Other ❑ s Number of living units: ____� Number of bedrooms t V �.. Number of aths --�____ Lot size ___�-_� Water Supply: Publics stem PPY� y ❑ Community system ❑,Private Depth-to Water Table _S-l- ft. � Character of soil to a depth of 3`feet: Sand E] Gravel1❑ Sandy-Loam- Clay Loam ❑ Clay [] Adobe❑ Hardpan ❑ Previous Application Made: Yes No.,�/ " ❑ R New Construc_tion.. Yes ❑ No �� „K TYPE.OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public se er is available within 200 fedt.} Septic Tank: Not of compartments-t DZeafrof�oundation__- Material___ s ------- ----------Liquid depth----------------------- Capacity------------- --------- is os I Field: Distance from nearest well-'- j `IDistance from foundation____!��- Distance to nearest lot line__ �--.---- • Number o{ lines,-------- ----- =Length of each line________../_2'v X sj Width of trench ._. Typo of filter materia__-- _ -- - + ---.------ �kTDepth of filter material---------[�---------Total .length-------.---•---_._�1�------- Seepage Pit: Distance to nearest well---------------------IDistance-from foundation_"__________ _.I_?istance to nearest lot Zine__.-____...--___ ❑ Number of pits----------------------Lining material----------------- - -Size: Diameter-------__--- i t -----------.Depth------------------- Cess Dol: � ------------ p Distance from nearest well__-_______---.__Distance from foundstion_-____--_-- ------Lining material__ Privy: Distance from nearest vrell______-_ ______________________ ❑ Size: Diameter-------------------------- ------------ Depth - - - ------------ ----Liquid Capacity----------------------------gals. ______-_- Distance from nearest buildin ❑ Distance to nearest lot line_ 9 i ------------------------------------------- Remodeling and/or repairing (describe):------------------------------------------ r ----------•-- ------------ 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 land rule `and regulations of the San Joaquin Local Health District. (Signed) ' ' --------- --------- -------- ------- -------- ----- --(Owner and/or Contractor) By: - I If, Title -- - -------------------------------------------------• - (Plot plan, showing size of lot, If, of system in relation to wells, buildings, etc., can be placed on reverse side). ...�'"�. .f FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-------------- - - ,_ DATE----- --- REVIEWED By--------------------------------- , ------ - ------------- � `"� --------------- BWLDlNG PERMIT ISSUED-------- -------- ----------- --- --- -------------------------- ------------------ DATE ......------------------------------------------------------ -------------------- Alterations and/or recommendations •---------- A --------------------•-- •----------------------------------- ---------------------- �� ------------------------------------ ------- --- - �-- --- - ----- _ _:�: __ -��lr--- - ---- -------------------- 6------- --------------------------------------------------------------------------- FINAL INSPECTION BY::___...-____ ------ Date-------- _1_4 ----------sIK------------------------•------ SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 Noah "C" Street Stockton, California Lodi,'California Manteca, California Tracy, California ES-9-2M I0-52 Revised W-2100