11969 - Laserfiche WebLink

Home Browse Search

Yo 3o APPLICATION FOR SANITATION PERMIT Permit No. ..L-4'2zll.... (Complete in Duplicated �// C', This Permit Expires 1 Year From Date Issued Date Issued .__�l_...,��- Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work here-:n described. This application is made in compliance with County Ordinance No. 549. 263 On left. JOB ADDRESS AND LOCATION------POVg 40--- —d:Rq%;__'�o Aa- ----2631)-----Nortb_.off--8-A-1 -e=_ At-------L�-- Owner's Name-------g9kTl_-A4A9gT--ki'--------------------------------------- ------------ Phone------------------------------- Address----------- ' Talth- ..----------------- ------------------- Contractor's Name--------The--DAY- & NI TSe_ptie--T&nk-_ServiCe --------------------------------- -------- Phone..BD_9746- --------- Installation will serve: Residence X;- Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: _31.____ Number of bedrooms ___2__ Number of baths __Z___ Lot size ------_____ Water Supply: Public system ❑ Community system ❑ Private P!] Depth to Water Table3P---- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam X Clay Loam l$ Clay ❑ Adobe ❑ Hardpan ❑ Previous Application Made: Yes ❑ NoX] New Construction: YesU No ❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Tank: Distance from nearest well__ 0*______Distance from foundation___ _ __-____ .Material-___.-___---_ --- r gk_________________ Septic well--- 50* of compartments __36"_____.___Li uid de th-- -Ift _ w-----.-Ca acit2_QQ p ! X T$e 9 l? � P Y-- ------ --- ------ Disposal Field: Distance from nearest well____-_______Distance from foundation_ e_.____-Distance to nearest loft liana_- Q _______ [� Number of lines----al----------------------------Length of each line_-_____4_._-----------------Width of trench_________._�# .________.___._.__ r Type of filter material_SePe---T4•-----Depth of filter material------14�__.______Total length--------9'a--___________________________ i Seepage Pit: Distance to nearest well___2.80----------Distance from foundation! ----------- to nearest lot line___©__.__--- 35a --.Depth---------- 20..... ........ � Number of pits_.�1•__.__._________Lining material---;'fiCk----------Size: Diameter.... ............ Cesspool: Distance from nearest well_________________Distance from foundation___._________.___.Lining material---------------------------_-__-__-_. . ❑ Size: Diameter------------------ ------------------Depth-------------------•---------------------w---------._Liquid Capacity-.--------------------------gals. Privy: Distance from nearest well-------------------------------------------------Distance from nearest building._.-.-------_----------------------------. ❑ Distance to nearest lot Iine--------------------------------------------- ---•--------------------------------------------- ---------------------------------- Remodeling and/or repairing {describe)----Hfl-----------t--------�3--e-------- O- -----G�----.-7------------------------------------------------------•----------- .------------------------------------ t1F3e #A ---- lam. ----------------------------------------------------------------------------------------------•--------------------------------------------------------------•-------------------------------------------------------------- 1 hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County. ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. (Signed)---=-7�4e DAY & i IGHT Sept c TanService._.. {Q Contractor)— By:-------------------------------------------------------- ---------------------------------------------------------------------.----(Title)-------------------------------------------------------------- (Plot --------- ---------------------- ---------------- (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 APPLICATIONACCEPTED BY------ ------- ------- ------------------------------------------------------------------------ DATE------- ---------------------- REVIEWEDBY------ •------------------------------------- ----------- -------------------------------------------------------------------- DATE-------------- ---------------------------I---I----------- BUILDING --- - BUILDINGPERMIT ISSUED------------------------------------------------------ --------- ---------------------------------- DATE------------------------------------------- ----------------- Alterationsand/or recommendations:-------------------------- -- ----------- --------------------------------- -------------------------------------------.--------------------------------- ------------------------------------------------------------------------------------- •------------------------------------------------------------------------------------------------------------------------------------ ---------------------------------- - ------ ------------------------------------------- ---------------------- ---------------------------------------------------------------------------- --------------------------------- 4 FINAL INSPECTION BY: - - 'E- ----------- Date.? _ - 0------ - --- ----------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street k Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2M Revised V59 F.P.Co.