11541 - Laserfiche WebLink

Home Browse Search

Permit No. `7 APPLICATION FOR SANITATION PERMIT (Complete in Duplicate) _> n Date Issued made to the San Joaquin Local Health District for a permit to construct and -install the work herein described. Application is hereby m , This application is made in compliance with Count Ordinance No. 549 !/ ------- --- ---- - --- JOB ADDRESS A D L AT -- ------- --------------------- ---- �----- ----- Phone------------------------------------ Owner's Name_ --- ---- Address----------------- -- ---- ---- - •-- -• - ----- ---- - --------- _. Phone_1;:0 Contractor's - Contractor's ame---------------------------- Trailer Court ElMotel ❑ ter Installation will serve: Residence [R�Apartment House ❑ Commercial ❑ _o .,_.�. ____ Number of bedrooms � Number of baths __/"- Lot size -0 _.-- -- --- -- sem------�-""-"�----""""" Number of living units: /S�ft. Water Supply. Public system ❑ Community system �rivate ❑ Depth to Water Table'/ Sand Loam ❑ Clay Loam ❑ Clay ❑ Adobe 9--Hardpan ❑ Character of soil to a depth of 3 feet:eSannd ❑ Gravel ❑ Y HA/VA: Yes E] No El Previous App' I lication'Made: Yes E] No [9--`New Construction: Yes E] No F TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or'cesspool permitted if public sewer is available within 200 feet.} Material______--____---------------- ----- pt' ank: Distance from nearest welt-----------------Distance from foundation_________________ . No. of compartments- Size-----_-" ---------------•------ Liquid depth--.------------- Capacity ________________________ - I i S______-Distance to nearest lot line______________ Disposal field: Distance from nearest well_ --Distance from foundation__ r� r Number of line ------ ----- _Length of each line-------- --;-�----Width of trench.____ss� -------- v l Type of filter material-S!_ e Depth of filter material___- ------0----Total length____-_ 1------ i 5 D"�_"___Dista e ro foundation -------.D-sten i� to nearest lot lin -•-- Seepage it: Distance to nearest well--- ---_ -"-- /� Size: Diameter----�rg---------Dep#'n_----- ------- __Linin material___ "_ e-FL Number of pits--.." --------- g Cesspool: Distance from nearest wel!________-__.---Distance from foundation___ -Liqing uid Capacitial y - gals. Deth----------------------------------------------- F1 --------------------------------------------- q p Y ❑ Size: Diameter--------------------------------------- p =--__"_------_ --Distance from nearest building----------------------------------------- Privy: Distance from nearest well------------------------ --------.-----.-- ❑ Distance to nearest lot lire----------------------------------------------- o ---------------------- - - - -------------------------- .. .. ---------------------- repairing, _____________________ Remodeling and/or repairing.(describe)--------------------- --------- ------------------- --------------------------------------------------------------------- ------------- --------- ----------------------------------------- - --- --------- --------------------- -------------------------------------------------------- - ! hereby certif that I have prepared this application and that the'work will be done in accordance with San Joaquin County ordinances, State a s, and rules an regulations of the San Joaquin Local Health District. wrier and/or Contractor] Signed) --------------- i ned e)_ I ------------------------- By------------------------------------------------------- (Plot plan, showing size of lot, location of system in re- etion t wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY i r ---------------- ------- -------- DATE-------.��--�I-�- -�-�-- --------------------- -- APPLICATION ACCEPTED BY �I�� I ..�._, == DATE------ ----------------------- -------- ---------- REVIEWED BY------------------------------------------- '-------------- ---------- DATE----------------- ----------- -------- ---------- ---------- 1 BUILDING PERMIT ISSUED----------------------- - --,------ -----------•------••------------------------------------------------ ---------------- Alteratians and/or recommendations:__-"__.__------ ---- __.___.____-_"-- 9 ------- --------------------------------------------- ____________________----------------------------- . .�., ___ ________ ___ i wr Date---- / _ � ---------- ------------------------------- FINAL INSPECTIL&_ _ . SAN JOAQUIN LOCAL HEALTH DISTRICT 132 Sycamore Street 814 North "C" Street 130 South American Street 300 West Oak Street Lodi, California Manteca, California Tracy, California Stockton, California .a ES--9-2M Revisea 1.57 VF-CO-