8888 - Laserfiche WebLink

Home Browse Search

:, APPLICATION FOR SANITATION,-.,iRMIT Permit No. -- --------- . !o (Complete in Duplicate) Date Issued (� �' App lica�ion is hereby made to the San Joaqu' Local Hea District for a permi`f to construct and install the work herein described. This application=is made in compliance with ounty Ordinance No. 549. JOB ADDRESS`AND LOCATION_____________/---� --_-------- -- € 171 ._. Phone------------------------------------- Owner's Name--------i!'�- ,(,v----._,Nl �/.nk------�- .5---------- Address.-------- f Phone--------•-------------------------- ------------------------------- v Contractor's Name___ ____ _ Commercial ❑ Trailer � P } Installation will serve: Residence [ Apartment House ❑ CCourt [IMotel ❑. .:Other Number of living units: -------- Number of bedrooms ___.___. Number of baths Lot size -- - -------•---------- Water Supply: Public system Community system ❑ Private jn Depth to Water Table -waft. PP Y� y �- Hardpan Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe P ❑ Previous Application Made: Yes ❑ No New Construction: Yes E] No TYPE OF INSTALLATION AND SPECIFICATIONS: - r (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well__.—t,x-Distance from founds ion__ t�_._r-Material---- ----------- - d!J - Liquid depth J�� Capacity of compartments_.___�__________________5ize____�-�a- --------------- No. --.--Distance to nearest lot line .-Y. Disposal Field: Distance from nearest weh._� istance from foundation__-- v.- Number of lines--------------�-- ---_ Length of each line------ -1---.---- -.Width of trench.---- -4 _--__-..-------=-- ;. Type of filter maferial_-_? Depth of filter mater' I____l..$..�-�- Total length___.1 ?a-----________________ Distancet o nearest lot line__ P�----. Ir - - --- r Seepage Pit: Distance to nearest well___ Distance from fauna` ion--- ' Depth---,,;2 -4G 5 - --------------- Number of pits.._-- _--_____--Lining material_--_ C9- -Size: Diameter__..___ ---- Ces pool: Distance from near est well-----------------Dista nce from foundation---------------_-_-Lining material--.__._____-____..._--_-____-- Size: Diameter------ ------- --------- ------- p -- --z De th------------------------------------- --------Liquid CapacitY----------------------------gals. O ❑ ___.__------------------ --------------- ._Distance from nearest building - Privy: Disfance from nearest well- ❑ Distance to nearest lot line--------------------------------------------- ------------------------------------------------- ---- 4 / I �r'rte-----------HCounfy Remodeling and/or repairing (describe}'-___._. __-_ 61. ---� --------- ----- ---------------------•---------------- ------------------------------------------- ----- .. A---- ,... .---- -fie�c 1 ...�rt�-�r .-- ` =I hereby certify tha ndhulespaepathisalli the Sandthatthoaquin work Heallkepine n accordance with San Joaqu ordinances, State laws, aregulations `- 'actor)and/or Contr ------(Si ned)--- --------------------(Title)-------"�' f" (Plot plan. showing size of lot, location of system in relation to wefts, buildings, etc., can be placed on reverse side) FOR DEPARTMENT USE ONLY DATE �------------ ---------- _ ------ APPLICATION ACCEPTED BY______________________ ___ �` �� ------ ----- ------------------------------------------------- REVIEWED BY -- ------------- ------------------------ DATE .' r -- ---------- - -------- - --------- DATE.--------- ---•-- ----------------------- --------------- BUILDING PERMIT ISSUED-------------------------- - ------------ - iterations and/or recommendations: -------- - - ----------• •-- - - -------- -- . ~ "� - ----- --------------------------- __ - ----------- = ( ..------ - ------------------------------------------------ -------------------- Date - ---------- --------- FINAL INSPECTIO -- N BY- ---- ----------(-[----- ` `\1` SAN JOAQUIN LOCAL HEALTH DISTRICT 300 West Oak Street 132 sycamore Street 814 North "C" Street 130 South American Street TracCalifornia Stockton, California Lodi, California Manteca, California Y ES-9 145446 ATWOOD