14518 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: -�---- ------------ ------ Permit No. -��'•• + ---------- ----- ------------ "= APPLICATION FOR SANITATION ---- (Complete in Duplicate) 7�1-� 62-- ---------------------------------------------- ----- � P P � Date Issued ------ --------- ------------------------------- This Permit Expires 1 Year From Date Issued Application is hereby made to the San Joaquin Local Healfh District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. iflN T '79r JOB ADDRESS AND I CATION_°' ---__.1. Owner's Name__--_______ M0 'SaK'a--------------------- --------- --------------- - ------------------------ _-------------- Phone Address.------ _"`.. � �._ - -------- Contractor's Name---------- Phone-------------------------------- Installation will serve: Residence Er'Apartment House [jCommercial ❑ Trailer Court E] Mote! ❑ Other [I Number of living units: I----- Number of bedrooms __ Number of baths 2�lvLot size -----4f --AC- • =-r-•-------------••------ Water Supply: Public system ❑ Community system ❑ Private Wr-Depth To Water Table S__ ft. Character of soil to a depth of 3 feet: Sand Gra el ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe❑ Hardpan ❑ Previous Application Made: (If yes,date--------------------) No 11-11' New Construction: Yes g�rNo ❑ FHA/VA: Yes ❑ No -TYPE"OF-INS-T-AL-LATION'ANDTSPI CIFICATIONS:'- (No septic tank or cesspool permitted if public sewer is available within 200 fee Septic nk: Distance from nearest well.._�a____DistajnJQ from foundation---- __.____...__.Mate ial__---- - __----•---_ No. of compartments______ _________ .--------Size- ___X1 x., ..Liquid depth-----1 -------------capacity---/ �J _... Ir _ 1Q Distance to nearest lot line s -.. Dispos Field: Distance from nearest well___. ____Distance from foundation__ _______________ i. Number of lines_______.��_ ___Length of each line_sl?_a_ - -----Width of trench__...__ ___ ...------- ic Total length___________________ :...._ ' Type of filter mate rial....�t��._Depth of filter material-----I�-__.__._ { Seepage Pit: Distance to nearest well----------------------Distance from foundation--------------______Distance to nearest lot line____.._____..___. I ❑ Number of pits------------------------Lining material---------- ------------Size: Diameter------------------------Depth---------••----- •-•-----... Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining materia__..__._____-___.__---------•-•-els. El Size: Diameter-----i--------------------------------Depth.------------=-----••----- -----------------Liquid Capacity-----------------------•----9 ' Privy: Distance from rarest well---------------- ------------------ = .---Distance•from nearest.,building--,-------.---------_---•-••-----...------ Distance to nearest [of line - `.... i t yr ------------------------------ ------------------------------- Remodeling and/or repairing (describe): '" = --•=------.-. > -•------------ --`------------ - ----------------•-------------•-----------_.-----_------......----...---•-•-------- -•------;------------------...------------------------------------- . _ ,. . . : -------- -------------_________________________________________________•______._"__._____-____.______--____.-____-_....___..-.___----____.____-_______.______-____._._____________...._________________._.___--._____._._ 1 hereby certify that I have this application and that-the-work-will-be-done in-'a-ecordance with San Joaquin County ordinances, State aw , and r es and regu 'ons of the San Joaquin Local Health District. Sinod 's - t -- ---_------------------------- --------� ----(Owner and/or Contractor) �-----.- ---------------------------------------------------- --=-- ------------------------------------------ - -- -------------- (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY ._ _ -------- --------- DATE APPLICATION -C� ------------------. I ' REVIEWEDBY-------------------------------------- ------------------ ------------------------------------------------•------------ DATE_._.__._.._...._....._._... BUILDINGPERMIT ISSUED--------------------------------------•-----------------------------------------------------------• DATE------------------------------------ ------------_------- Alterations-and/or-.recommendrations-------------- -:------ ------------ ------------------•-••----------------------•------ -- - "� --------_------------------- ..._ - = - -----------------------•-----•------•------------------------------------.•---------------------- ---- ---- ---- '`-------------- ----------- -----------•----------------•- --------------- # --------------------------------•---- -..-BY' 'C1. Rate FINAL INSPECTIOM SAN JOAQUIN LOCAL HEALTH DISTRICT �4 130 South American Strut 300 Wast Oak Street. 144 Sycamore Strout 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California E5 9 REVISED B-59 2M 5.62 ATLAS i'