8512 - Laserfiche WebLink

Home Browse Search

APPLICATION FSANITATION PERMIT Permit No. OR _. -- [Complete in Duplicate) Date Issued is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. Applica i{'on Y This application is made in compliance with County Ordinance No. 544. - �,� -----� f Owner sN JOB D amse AND LOCATION------- ------ ---= ---- - -------------- Phone------------------------------------ --------- Address------- ----------------------------- ------------- Ph one Contractor's Name------- _ - ,/•�- -- '�-•"" '�� Motel ❑ Other El will serve: Residence Apartment House ❑ Commercial El Trailer Court ❑ Number of living units: -_l--_ Number of bedrooms .4?.. Number of baths __L_ Lot size _ ,� Private ❑ Depth to Water Table ft. Water-Supply: Public system El Community system , Adobe Hardpan Gravel Sand Loam ❑ Clay Loam ❑ Clay ❑ p ❑ Character of soil to a depth of 3 feet: Sand ❑ ❑ Y . Previous Application Made: Yes ❑ No l�r New Construction: Yes ❑ No TYPE OF INSTALLATION AND SPECIFICATIONS: - permitted. if public sewer is enfeet.) (No septic tank or cesspool -,r- Septic' -Tank: uid depth---_DistanceromWs� welL _ -Distancefromfouclationn- .0?------- f Ca acitY - No. of compartments----- - - ---------------Size_ IPr�.- - d istance from foundation- ------...Distance to nearest lot line--A-4p Disposal Field: Distance from nearest we I-.� i. Len th of each line-_-�Q--------------Width of trench.__��-------- --•--• Number of lines----"-"-_�-- gr • - Total lengfih------ -----Q----•---- -----•---•-`.. ! De th of filter material- -------------- Type of filter material- __ __ P a�nce to nearest lot line-A-__---- Pit: Distance to nearest well-.__lT��lt- ----- � Disfiance from ou_no tion__---•--• Linin materia!-' � ilze: Diameter----------------------- --- -Depth------ a--------- Seepage " Number of pits------------------- g - Distance from nearest well ----------------- from foundation.- Liquid-Ca acit gals. Cesspool: Depth q -Capacity - ❑ Size: Diameter- -- -- ----------------------- --- p -------------- ------- ---.. . -- - - - . ------- Distance from nearest building-------------------------- ------- Privy: Distance from nearest well-------------- Distance to-nearest ofi ane--------------------------- _ C` i :'$ - -. -- .- .-- ----------------I---------•----- 20 -.- I Remodeling and/or repairing (clescnbe): ---•-------•------------------------------ ----------•---•---••--- ------------------ i ------------------•-----------------------------------•---•-•------;------------ ------------------------------------------. -------•- ------ -- - ---- � lication and that the work will be done in accordance with San Joaquin County I hereby certify that I have prepared this app ordinances, State laws, and rules and regulations of the San_J aquin Local Health *strict. r=Contractor) 61t (Signed)--•----------------- -------- (Title)-- -- By=---------------•--------------- --..- (Plot plan, showing size of lot, locati of system in relation tb wells, buildings, etc., can be placed on reverse e). FOR-DEPARTMENT USE ONLY jDATE-------- - t ----------- APPLICATION ACCEPTED BY______________________ � DATE ATE.----- --- ------------- ------------------•--------------- ------------- •:- BUILDING PERMIT ISSUED.------_ : ---------- Alterations and/or recommendations__________________ { --------------------------------•----------- ------------------------------------------------------------------------------ ' ----------------------------------- Date-_ -7 FINAL INSPECTION BY:.. --------------- ._. - ".- E SAN JOAQUIN LOCAL HEALTH DISTRICT 300 West Oak Street 132 Sycamore Street 914 North '"" Street 130 Sou+h American Street Manteca, California Tracy„California Sfacicton, California Lodi, California ” E5-9 345446 ATWPLEP t _�'� � •--