77-283 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT + Permit No..-------------------- ---------- --------------------------- --- --------- ---- (Complete{in_Triplicate) 6�177 �.=..�. ,b Esc . --' . ' ",-' ate Issues ----- ------------------- --------- - NIN This Permit Expires 1 Year From Date Issued 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 and existing Rules and Regulations: t ' -- - '�` c_ �� CENSUS TRACT.-_-..- --- --- --- - <..-.... . .- r -- --- ---- ------------------------- ---- J08 ADDRESS/LOCATION [_ - --------------'------ h one ------------- Owner's Name.. Address. - -- - ------------ -------------- ------------ ------- - Zip-.-" s ,� 5 -- - -- , Contractor's Ndme --------!--. L' en a `# �1 �3 Phones u�--tt- -- --' ---- - c ? - Commercial Trailer Court ❑ } i Installation will serve: silence Apartment House ❑ ❑ ._ - # :--. -• 1, ' L-Mote Other, � = •�' w, � I _ __n Number of,'ivin units:_"�_. Nurriber.of.bedrooms"`�'�Garbage"Grinder ..,.Lot Si a .._ Water Su Public System and n. ---------------------------------� i + ---Privat y ame - -- ---'- e ' t " ❑ rrSllt❑� Clay ❑ a Peat Sandy Loam �] Clay Loam Character of soil to a depth of 3 feet: ' Sand; . _.. , ` Hardpan Q Adobe ❑ rFill Material. .. If yes,type --- -- - ---' -- ! r (Plot plan, showing size of lot, location of sys�m in relation to, 'wells, buildings,(etc. must be placed on reverse side.] NEW INSTALLATION= !(Not'se tic ` l tank or seepage ;plt perm`iited if public�!sewer is available within 200 feet,] { P t. s + 4iz` ' F� . -° --- ---------------------- PACKAGE ------- -------- PACKAGE 1REATMENT SEPTIC TANK e.----'-------------=---- ---- -- .----- Liquid Depth. .-'"---- - Capacity= = €TYPe 1 �:�., - o. Compartments..- _- w.. L. ..M :. _:a stasis � N _= Foundat - Prop. Line -#- i - --------------- ion.I .. ..Distance"t.o nearest:-Well:?;._-. l� = to a .. --- ------ j ` k Length of eoch line. Total Length - LEACHING LINE [,1 No. of.Lines---....-.,-, :;.- -- -T j"" " s -- i ='D Box -: I ....Type Filter Materid_l�_ =- l" P _---- ., . .,..f ,.�-...� . ., Depth Filter - Materia' � � . F --�-, - .. EDistance.toc4w - Line-.:. } ] : . nearest: We11 .. Rock F No � �da e"tY filled Yes ❑ ; �" :". Foundation--.r oP SEEPAGE PIT [ } Depth..--} ---'----- Diameter.- Num e " ... .. t i Water Table Depth -- RockSi� p e-- iL -- ----- --- --- - Dktsince'to nearest:'Well--------•---------------- ---=- ----- Foundation -- • sop. Line ----- REPAIR/ADDITION [Prey Sanitation_Permit#-F-------- ----=- •---- -_-------- Date--'- ------ -----------,----- = ) a ? - --------- -------- --- � l E Septic Tank (Specify Requirementsl_-- C - , 8 =: _ i -3 ' p Y q - , I f /----------- Dispos I Field(5 ecif Re uirementsy_. ____�__ � r` ----------------------------- ----- �.."_ -------------- ------------- ----- ----- - , _ - --------------- -------- ---------------- ---------------- _r q � � • .� ---' (Draw existing and required addition on reverse si( e] I hereby certify that I have prep ared this application and-that the .work will be done-in- accordance with San Joaquin County Ordinances, State Laws, and Rules and Regulations of, the San Joaquin Local Health District. Home owner or licensed agents signature certifies the following: , -- ' "I certify that in the performcnt of the work for which this permit is issued, I shollnot employ any p irson in such manner as fy t I to become- s le t to Wo. man`s ompensation: laws of California."- = i Signed .." .._Title - --- k (If other fhan'owne [ ri FOR DEPARTMENT USE ONLY DE --------------- AT ON } - ------------ ------------------- DATE '-------------'--=----- ------------------ DIVISION = _' ; DIVISIONIOF LAND �� ------------- � - ---------1-2 ------a ----_ L - -------------- ---- ---- --- -------------- --------- I ADDITIONAL COMM I --------------- ------------------ --------- --------- r ------------------------------------------------------- --- -- ---- _ .. .. Date -' '----'---- r. Final,Inspection by: -_r." - -- F85 216 7 RECO E !7 3M EH 13 24 SAN JOAQUIN LOCAL HEALTH DISTRICT