16187 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: r APPLICATION FOR SANITATION PERMIT Permit No. 7 ------------------------------ (Complete in Duplicate) --- ----- This Permit Expires 1 Year From Date Issued _ Date Issued Application is hereby made to the San Joaquin Local Health District fora rmit to construct and inst Il h� k h reiescribed. This application is made in compliance h County Ordinance No. 549. I�f 3 r.. Ar< vZ.E.S P60 UV JOB ADDRESS �ANCATIO _ - +� S --•-x----- ----------•------------Owner's Name.?. ----- Phon .__,�&-- ----- -- Address - -------------- - -----_------------- - � ------------ --------- - Contractor's Name- -, � PhonQ- - Installation will serve: Residence Apartment House [j Commercial E] railer Court ❑ Motel ❑ Other ❑ Number of living units: _ .__ Number of bedrooms Number of baths ___._... Lot size __ 02 Water Supply: Public system ElCommunity system ❑ Private�De;qztm Table __...___ ft. I k �1 Character of soil to a depth of 3 feet: Sand ❑ Gravel E] Sandy Loam ❑ Clay ❑ obs ❑ Hardpan Ci Previous Application Made: (If yes,date_------------------) No ❑ New Construction: Yes El No FHA/VA: Yes ❑ No y C TYPE OF INSTALLATION AND SPECIFICATIONS: A. No septic tank or cesspool permitted if public sewer is available within 204 feet.) S T� Distance from nearest well________________Distance from foundation--------------------Material •____..______.______..____ o. of compartments------- -- ize------------------------------_Liquid depth- Capacity D sal F' Distance from Weare # well (,----Distance from foundation.....___ /X--'Distance to nearest lot line--------kK..-- Number of lines_____.__ ______ ___ _Length of each line_._.._ --_-..Width of trench.___ Z_ -`f-__------ Type of filter mat al p !�__Total length.........................' - / _Depth of filter rnaterral______,� ' - - _ Seepage Pit: Distance to nearest well________________ Distance from foundation--------------------Distance to nearest lot line---- _. ❑ Number of pits-----------•----------Lining material-----------------------Size: Diameter--- __-Depth----------..-_____......___--_-._____•._- Cesspool: Distance from nearest well_________________Distance from foundation-------------------.Lining material----------------------._____. _._ _ .❑ Size: Diameter--------------------------------------Depth-----------------------•------- -----------_Liquid Capacity -------•-----9a--- Privy: Distance from nearest well--------------------------------------------------Distance from nearest building ❑ Distance to nearest lot line---------- --•-------------------------------------------------------------- Remodel' g and/gr repairing (�Iescribe):__- ------ -- - --- ---- - --------- - ---- r j :____./___- -- ---- ----•---------------- --------------------- -------- ------------------ ------------------ •--------------------- -----------•--------------------------------------------------------------------------- ------------•-------------------------------------- -- hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, S t laws, an rules and regulations of th San Joaquin Lot Health pis rict. Si g ned By:-------------------------------------------------------- (Plot -------------•-------------------••------------(Plot plan, showing size of lot, location of system in relatic o wells, but dings, a ., can be placed on reverse side). FOR DEPARTMENT USE ONI.Y APPLICATION ACCEPTED BY -----•---------------------------- -l•----------- DATE_... _ REVIEWED BY-------------------------------------------- ----- - DATE_--- -- -------------------------------------- UILDING PERMIT ISSUED-------------------------------------------------------------- --•----- DATE----------------------------- ----------------------------------------------------------------------- ------------------------ Alterations and/or recommendations:_____________ .-------•---------------------••---------------------- ------------I------------------------------------------------------------- --------------•---------•---•---------•------------;-----------------•-------•------•••••----------••------------...------•------•-•--------------- ---------•-----------------------•------ --------•------- ---------------- --------------------------------- ----- ------------------ FINAL INSPECTION BY:.,,"d Date....... ----- - - � /p� -__ f SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California ES 9 REVISED 8.59 ZM 5-62 ATLAS