79-595 - Laserfiche WebLink

Home Browse Search

~T ._ FOR OFFICE USE: FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT '� 12 Permit No --------•--------- (eomplete in Triplicate} =- . . -- . Date Issued..7- -------------------------- -- --- (� This Permit Expires 1 Year Fror Date lssu n 1s hereby made to the S --- ------------ i for a a Application y an Joaquin LocalOrdintancDesNot549 and existing Rultes and Regulations:install the work herein described. PP _r--- — This application is made in compliance with County f ,� —` A US CT-------- JOB ADDRESS/LOCA, N----- <; Phone__ - 'P --------------- -- Owner's 1 Ci _ - - - -- _- - k f 1 .. .. Address !'c 1 s ---- t bL #� ten e , O S�a� �Phoner� Contractor's No ..C ; ` i ' f"» 4-`-t :Trailer Court ❑ "' ' = Apartment Hou� � �meraal ❑ i Installation will serve: Residences p _ Motel �7., r a° ----•- ---------- the _ iz .- - k - Number of.bedr.00ms;-- :_ .Garbage Grinder_.' •----:L a Number v# living units: ------- r t j • of se ----- --- _ . Publics stem and:name_ '._:_ -------- :.; ::-:.. l z t. . iva e Water Supply: Y _ Sand Loam Clay Loam ❑ :Silt Clay Peat❑ Y Character of soil.to a depth of 3 feet:•sN Sand ❑ ❑ y �.' `e - ---- t ' Hard an Adobe❑ Fill Materlol ------�_..1f yes, type---- Ado p ❑ , buildin is,tetc..must be placed on reve-rse side.) j (Plot plan, showing size of lot, location of system in relation tojw fis, : •.. •.a..._ . i• �' ' `� it 'ermitted 1f public sewer is ava*1able within 200 feet,) NEW INSTALLATION:' (No:septile tank or seepage p' p € t ------------------ ----- - - ----- T t 1 h. Size- - -- ` •---}-• •''•^~' Liqu'cl Dept PACKAGE TREATMENT' [ ] ;SEPTIC TANK [`] _-_ y: • - -- � ,-r_.�._-- --�• No. Compartments__---�---- Capbcity_-- -_ YP r j ; --. t. c t � - - Line =----- ° : - - . tante to nearest: Well.--------------------� - ,. -- = Foundation_: �_,•----- =Prop. Dis _ i - t h line.------ -=. . _Total,Length { LEACHING LINE [ ]. No..of Lines-------- -- -- - g -----_ Len th vf.eac -.De th Fliter Material x_ _------------------- 'D' Box �-- -.-Type Filter MafierlaL_ �• p . - --. ------------------ -----� . . , . ... ...t,....--_._.-.�.... � Line— -- Distance to nearest: Well -.I-. .Foundation Property Number h n SEEPAGE PIT [ l Depth -------Diameter k 5 e - s � __ ..7... .�-- . -- ;•_ . Roc ---- - -- -- ----- ------- ------ - : � �. ock ed v S • i Water Table:Depth ;---- = - ---- --- f ► .. ;. .... ----------- ... ---' -----Foundation--'--- -=----- ---------- Prop Line -,---- -•--- Distance to nearest We{'I.-- - -': -�---- ----------- . NRS REPAIR/ADDITION (Prev. Sanitation?Permit# __ = ' f Dis oral Field (S eclfy.Requirements�_..__SC- - j Se tic Tank:(S ecif Re ulremen =p , - - ---- --------------------- ------ e -- e -------------------------------- aw existing and required add f.. on reverse side) ce with San I hereby;ceftify that an 1 have prepared this application and that tsa^oa u nlLo aldHealth Distrctt.. Home wnerr or�licens d agenoaquin ts Ordirvances State Laws, and Rules and Regulations of the q signature certifies the following: P p ' 'rson in such manner as "I certify that in the performance of the work for which this ermit is issued, I shall`not employ any p' to become subject t4� 6 an's Com sation,.laws of California." , 1 Signed -- v . . I G - ----- g - B -------------- WTit e ,�]f.. ther than owner] FOR DEPARTMENT USE ONLY; ; = DATE._.-- ------ - -- ------ ----- ---- APPLICATION ACCEPTED ------------------ D ATE DIVISION OF LAND NUMBER:._,:.-..-----. ------------ -------- - - ADDl710NA1 COMMENTS_..__ --', --------------- --------------------=--------- ----- ---- - - . • - --------------------- ------------ . .- -- ----------------- -- t �l Date Fina! lnspection�b -----�- ---- y:.------==�'=---�-i- � -- F&s 21677 REV. 7/76; -1,N 13 24 S JOAQUIN LOCAL HEALTH DISTRICT