10592 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No. .- ��=-Issued -F- (Complete in Duplicate) Date 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. t JOB ADDRESS AND LOCATION________ l QQd r- Mr. & Mrs .' E. Ortiz------------------ ----- ---------------- Phone.- Owner's hone.Owners Name------------ - -------- Address. SamC -----------•-------• ----=------------ ------------------•------------------ - xo 2 06 -DAY & NIGHT-----Septic-.Tank--Service-- --- -- - Phone Contractor's Name__-___-I___-___-__ Installation will serve:-Residence ❑ Apartment House ❑ Commercial Trailer Court ❑ Motel ❑ Other ❑ I 6 f baths _ ---- Lot size ------�- ASC'--•---------=----------------------- Number of living units: 1-- Number of bedrooms ___ __ Number o Water Supply: Public system ❑ Community system ❑ Private Depth to Water Table -----� ft•plus of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam JX Clay ❑ Adobe❑ Hardpan [] ! w Construction: Yes ❑ No Qi[ FHA/VA: Yes ❑ No [ Previous Application Made: Yes F1 No C] Ne '+lF1E TYPE OF INSTALLATION AND SPECIFICATIONS: (Na septic tank or`cesspool permitted if public sewer is available within 200 feet.) w4 _ a Septic Tank: Distance from nearest well _________ Distance from foundation Liquid de th- Materia4------------------------------------------- Septic --_-- - Opacity________ _________.-. EK.sting ,N6!-,6f compartmenfs---- ---- Size---------------- q p , t ......Distance to nearest lot line___ ._________ Disposal Field: i 'Distance :•om nearest wel .LF`3__ _-.._Distance from foundation____-�-_- ExEbting i Number of lines--------------- - ------ Len....Length of each line 12 s�� XXL-'--.Width of trench._-=----------------------------- j - Rock e gh of filter maten � 3g --r• Total length--------------------------- • - ; & ADD Type of filter material,#-GO-bb-Ies p t: �'' Seepage Pit: ;rs Distance to nearest well__ Distance from foundation___- ___..Distance to nearest lot line------------.___- ' Number of pits------------------ ---Lining'material------------------------ well -------------------- Size: Diameter Depth ❑ } �� r Cesspool: ', Distance from nearest well_________________Distance from foundation -_.____________.Lining materia!__--_._______----------- ----als. Liquid Capacity 9 ❑ Size: Diameter------------------------------------ ------ - ------- --- --.- ------=--_Depth------- --------- -------- ----------------- - q P Y-ti- ------------ ---------- Privy: Distance from nearest well---------------------------- Distance from nearest building---------------------------------------- ❑ Distance to nearest lot line------------------------------------------------'-------------- *Rest Home **Supplementary Drainage - ------------------------ - Remodeling and/or repairing (describe _________________________________ _____ ------------------------------------ --- --------- ---- ________________________________ _____________________ - 5 ---------------- that wi done i I hereby ta +hat a I have es prepared regulations olf +he Sant oaquinhLocaikHeal}1eAis#r cin accordance with San Joaquin County ordinances, S (Signed)---DAY___'3eti-----NIGHT------St it--Tek--SGr'v .CI - - ------------------------------------ �r Contractor) ----- 7itl ---------- BY:--------------------------•-------------------•---------y--------------- ---- ---- e) (Piot plan, showing size of lot, location of s stem in relation t "ells, buildings, a+c.- can be placed on reverse side). FOR—DEPARTMENT USE ONLY $Y__=- DATE- - -`i� ---------------------------------- APPLICATION ACCEPTED . DATE------------ - ------------------------------------••------ ----•------------------ REVIEWEDBY-------------------------------------------------------- BUILDINGPERMIT ISSUED---------I-----------------------------------------------=------------------------------------------- DATE Alterations and/or recommendations*_:',---------------------------- -- ---------------------------------- ----------------------- ----- -------------------------------- ----------------------- - ��- ,--L =-�°' ---_-- _- --------=- --------------------------'---------- FINAL INSPECTION BY=---- SAN JOAQUIN LOCAL HEALTH DISTRICT 132 Sycamore Street 814 North "C" Street 130 South American Street 300 Wast Oak Street y Tracy, California Stockton, California Lodi, California Manteca, California ES-9-2M , Revised 1-•57-F.P.00.