6403 - Laserfiche WebLink

Home Browse Search

I APPLICATION FOR SANITATION PERMIT Permit No. .--1�..T...-� _: (Complete in Duplicate) Date Issued .-_. ",nJ, COS- Applica4'ion 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. (Trailer by new DMA Market) I : Rt. 2 Box x---Acampo Collier_Rd..--&--.Hi -Way---99--------------------------- JOB ADDRESS AND LOCATION ------------------------------------------- Owner's Name---------------Russell From® ----------------------- Phone-------------------------- ---- Address--------•-•-----------------``amgm -------------------------------------------------------•---------------------------------------------------------------------- ------------------------------------ Ho ----------------..-.:------ -----. H� 69--�7 Contractor's Name-------- --------- --- --------------------------------- ------ Phone----------------------------------- Installation -- --- ---- Installation ... will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ® Trailer Number of living units: 1- Number of bedrooms --_ •. Number of baths .1-.- Lot size ----751--X-1-59-1--------------------------- Water Supply: Public system ❑ "Community system ❑ Private ® Depth to Wafter Table -5a__ ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay [I Adobe ] Hardpan Previous Application Made: Yes ❑ No)[] .New Construction: Yes ❑ No ❑ To gerve 1 Trailer• { I 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-49-1----.--Distance from foundation-,.10_-_-:_.--Material_CC-_Brick ---�' ---Ca aci --. . No. of compartments-..2---- - -------- -- ,56" II II [T $e _Siz -.----��------�--�--•Liquid depth .---- -- - P tY -------- • Disposal Field: Distance from nearest well--X.----------Distance from foundation--------------------Distance to nearest lot line.--------_------- ❑ Number of lines-----------------------------------Length of each line------------------------------Width of french----------------------------------- Type of filter material-------------------------Depth of filter material-----------------------Total length-----------------------------------...... 1 Seepage Pit: Distance to nearest well.1001----------Distance from foundation--------------------Distance to nearest lot line---V-------- �- C Number of pits---..-. .---.--Lining material5XACX------- Size: Diameter.33"-------------Depth__39.t.---- --- Cesspool: Distance from nearest well-----------------Distance from foundation,_-------------------Lining material------------------------.___-__------. []<. Size. Diameter-------------------------- ------Dept h ------------------- -- -----Liquid Capacity ---------------------gals. ,..-�sw-� -- •�i:�e _.r �-r�..-_ , r--�� - - Distance from nearest buildin -. Privy: Distance from nearest well---------- ---------- ..----.-. g ❑ Distance to nearest lot line--------- --------------------------------- -------------------------=--------------------------------------------------------------------- Remodeling and/or repairing (describe):---Hard---pan__8rea..__=_leaching...drans___not___practcal;____ he J ---.i-il---up---dUrinZ._th_e.--raj.n,X--.aeaaon,.-------- The---abo-ve----specs--have----pressen---to----be-------- --------- _..e-rbc Qtivea--------------------------''-------------••--------------------------------------------------------------------------------------------------------------------------------------------------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of t e San Joagpin Local Health District. , r (Signed)------- N .,----IHC-e-------- t, - t - (��r Contractor) -- ------ ------ -------------- --- --------- --- -- (Title) FF-Dtl> tQr-- _-PARR (Plot Ian, showing size of lot, Iota p g tion of system in tJ lation to wells, build gs, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY.... ---------------- --------------------------------- ------ DATE-- " ---------" REVIEWED BY DATE-- -------r --` --- ---------------- BUILDINGPERMIT ISSUED--------- ----- — ------------------------------------- DATE------------------------------------------------- -- --•- Alterationsand/or recommendations---------------- - - --------_-------------- --------------------------------------------------------•----- --------------------------------------•----------- -------------------------------------------------------------- - ------- ---- ----------------------------- ---•--------------------- --------------- ------- 00 c� FINALINSPECTION --- ------ --- - ------------- --------------------------------- Date.----------------- ------ ----------------------------- 4- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 306 West Oak Street 132 Sycamore Sfreef 814 North "C" Sfraet Stockton, California Lodi, California Manteca, California Tracy, California \ ES^'9-2M 145446 AT-000 12-54 - — }r t�