11882 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No..__..1��_5�.. (Complete in Duplicate) Data Issued ---- '1 Th' P E 1 Y F D t 1 d Is ermiI x ares ear rom a e ssue 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. JOB ADDRESS AND LOCATION -------'l/Alr�'C.�'� Owner's Name.fa/�41 ��•f�-'---------------------------- - Phone Address---------------- e-----.___-,•--------------------------------•--------------------•-------------------------------------------.--.--- ----- ------ ----------------- Contractor's Nam___�-----------i�---,D_r�1.S-----„------ Installation will serve:. I Residence` Apartment House [:]Commercial E] Trailer Court E] Motel ❑ Other ❑ Number of living units: ____/-`Number of bedrooms __Number of baths ___a{___ Lot size ------ ----------•--------------- Water Supply: Public system Community system ❑ Private ❑ Depth to Water Table __o"oft. Character of soil to a depth of 3 feet: , Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ AdobPIT Hardpan ❑ Previous Application Made: Yes ❑ No New Construction: Yes ❑ No FHA/VA: Yes E]Np�` TYPE OF INSTALLATION AND SPEClF1CATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septie�a . Distance from nearest well-________________ Distance from foundation ------------------- Material-______________-_______.___________---__-______. No. of compartments -------------------------- Size ---•--- ------------------------ Liquid depth -------------------------- Capacity ------------------ 'I3°isp Distance from nearest well-- WAA*rDistance from foundation____ ____ -Distance to nearest lot line --- -.______-- / si Number of lines__,________ __.._-----_--_ Length of each line------ �i jr____.W�dth of trench__ ________________ Type of filter material.____ S _____Depth of filter material ------ length -------- f I.___:________________�____ ++/I ir Seepa Pit: Distance to nearest well___A/��[�_ __Distance om foundation___._ /0 -------- Distance to nearest lot line___.6._________ Number of pits ------- /____________Lining material --- kjDC '------Size: Diameter--__ _r_____..Depth__�5- ---------------- Cessp ol: Distance from nearest well Number from foundation -------------------- Lining material _-_.____________._.------ ____-______. ❑ Size: Diameter-------------------------------------Depth-----------------------------1--------==........... Liquid Capacity- ' ------------------------- gals. Privy- Distance from nearest well ------------------------------------------------- Distance from nearest building ---------- ------------------- ..____.._. ❑ Distance to nearest lot line --------------------------- --------------------------------------------------------•- --------------------------- --------------------------- r Remodeling and/or repairing (describe):___ _--- -- ----- --- --------- t-4-1 ----- — ----- .rx.o,� ---------------------------------------------------------------------------------- ---------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State la and rules a ulations of -the San Joaquin Local Health District. --. Owner and/or Contractor (Signed------- v s----- -- - -- -- -- ------ / I By:-------------------•------------------------------- -- ------ ------- ---- fie)---- ------ ---------- Y (Plot plan, showing size of lot, location of syste in relation to wells, buildings, et can be place on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-------;�""�i"�=---------- ------------------------- DATE --------- "' I = REVIEWED BY. ------------------------------- -------------------------- �----------------------- -- %, REVIEWED BUILDINGPERMIT ISSUED -------------------------------------------------------------- ---------------------------------------- DATE--------------------------------------- ------------------ _ Alterations ---- ------ Alterations and/or recommendations: C� FINAL INSPECTION BY: ------------------- Date-----. �' -=�,F --0 130 South American Street Stockton, California ES -9 2M Rwls d 8-'59 F.P.Co. SAN JOAQUIN LOCAL HEALTH DISTRICT 300 West Oak Street 132 Sycamore Street 814 North "C" Street Lodi, California Manteca, California Tracy, California w v,