22501 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: ' 1 11 APPLICATION FOR SANITATION PERMIT Permit No. � / ----- -------------------- -------- (Complete-in Duplicate) This Permit Expires 1 Year, Fro_ m Date Issued Date Issued .��._ --------- -- r Application is hereby made to the San Joaquin local Health District)for a permit to constr ct and install the work herein described. This application is made in compliance with Count4udin.,,� No. '5149. 1 ,Ql F JOB ADDRESS D LOCATIONtY- --- f�i�ff� d,��'I i` ==/6------------------------------------------- --•------------ r --------------------------- ------------------ --- Phone.Owner's Name------- --------- - --t-- .....----- --- -- -- -----tl--------- •----- - ----- -- -�- Address----------------- �--- -------- �- ------------------ Contractor's Name---------- 7�~ �= ' --- Q Phone.. r i Installation will serve: Residence [Apartment House Commercial ❑ Trailer. Court ❑ Motel ❑ Other ❑ Number of living units: ----- Number of bedrooms -1.- Number of baths_-.' Lot size ...... _---------.-------------x Water Supply: Public system ❑ Community system ❑ Private Depth to Water Table ------ - ft I Character of soil to-a depth of 3 feet- Sand E] Gravel ❑ Sandy Loam ❑ Clay Loam ❑ ClBy [Adobe E] Hardpan C] Previous Application Made: (if yes,date-...... ......... ) No ❑ New Construction: Yes ❑ No ❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well....-------- Distance from foundation----------- --.,_Material..---------------------------------------------- - ❑ No.,of compartments- ------- ---Size---------- - ---- -----------Liquid depth-----"-- ------ --------Capacity-----------••---------- Disposal Field: Distance from nearest well___..............Distance from foundation---.._------#_-=..Distance to nearest lot line................. ` ❑ Number oflines.------'-------------------�-__---Length of each lire--__-----------`_--`-------.Width of trench---------.---------_-----------.--- `J h See a rt: Dista oef toeneaaest iwlelL...��-...�, ------D scan of frfilter'material..........:----------Total length-----....-----.-_-________________________ th t7 Distance to nearest lot line--.._------- p g YP gm foundation_,1E1---.--._--. I ETNumber of pits... .---/________.Liming material-- _S_�_ ,..--- S ze: Diameter-------��`-----Depth -- ----------- ----------- Cesspool: Distance from nearest well ----------------Distance from foundation... _:__-_�::�__ -:Linin material...-__--------.- ----- , l ❑ Size: Diameter- -------- �; } Depth E -:�.:- - Liquid CapacitY -------------gals, - s - ++ Privy: Distance from nearest we]-----------.......................'1_.__-_------Distance from nearest building....-__--..- _. ❑ E Distance to nearest lot line---- ------------------------------------------------- Remodeling -------- -- ---------'- -------------------------------------------------- S ; ______________*_---'"�--_---_-------- ------------------------------•------------------------------.---------------------------- ----- --------------.--- ----_• r Remodeling and/or repairing (describe):-..._............... f ------------------------- --------------- ------ c ' '- I ,, a -- •, •� ----- ----- -------------------d'--"---------------------------------------------—---------------------------------- ------------------------------------------------------- ---------------------------------------___ I hereby certify that I have prepared this application and that Cfhe work will be done in accordance with San Joaquin County ' ordinances, State s, and rules and4gullafions of the San•Joaquin Local Health District. {Si ned �* - -----.-{ P'and/or Contractor) 9 } -------- -13 � - --af---------- ----- - (Title} y:-- (Plot plan, showing size of lot, location of system ' relation to wells) buildings, etc., can be placed on reverse side), r a1 FOR DEPARTMENT USE ONLY S�II APPLICATION,ACCEPTED. r-- ---- ell - -- --+ --- - y� y - .., r "DATE=r--=--- ............... -------------------------- IDATE-------------------------------------------------------- BUILDlNG PERMIT ISSUED-------- -- --------- -_---...-..--- - -------- ---------- ----- - ---- --------- ------ REVIEWED Y----------------- ------- -- ------------ Alterations and/or recommendations:--------------------------- ... -- -- - ----------Ill--------- - - -•-- ------------DATE-----•-•---------- --------- ----------------- -- - __ _ IM ------- --- --- .------..... •--------- M--------------------•-----------------...............------------------ ---------------------------- ------------------------------ ----------- ----------------------- ----- --------------- ------- --------------- -------- ---------- ---- --------------------- ---- ---------------- ------ IM----------- --------------------..--- ... .................. « FINAL INSPECTION - ---- ------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Naselton Are, 300 West'Crak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi. California Manteca,California Tracy,California E.H.9 2M 1-67 Vanguard Press i ,r i I ��