2673 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No. .- -- .Cf (Complete in Duplicate) Date Issued _�. .r, �' al Health District for a permit to construct and install the work herein described. Application is hereby made to the San Joaquin Loc This application is made in compliance with County Ordinance No. 549. - - ------------------------------------------ JOB ADDRESS AND LOCATION---------------- hb4__South-Drake__� rset�-_$tnckton--------------------- - Fred Layton ------ Phone ` " 6 ----------------- ---------------------------------------- Address-------------------•---------------------•----------- -- � jagmo Contractor's Name--------------------------------- ---D*-- * pgFtRISH-A-SONS--INC.----------- -------------x---------- - Phone---- •9----967--- - -----•--------•- Installation will serve: Residence]X Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel-❑ Other ❑ ------------ Number of living units: __1---- Number of bedrooms Number of baths __x____ Lot size 6Y--Z-100#------------------------ Water Supply: Public system ❑ Community system ❑ Private IX Depth to Water Table -------- ft. l Sandy Loam El Clay Loam [I Clay E] Adobe. Hardpan ❑ Character of soil to a depth of 3 feet: Sand F] Gravel ❑ anY Previous Application Made: Yes ❑ NoU New Construction: Yes ❑ No ❑ Supplementary Drainage.... I TYPE OF INSTALLATION AND SPECIFICATIONS: ` (No septic lank or cesspool permitted if public sewer is available within 200 feet.} Septic Tank: Distance from nearest well-----------------Distance from foundation--------------------Material___.______-_____-____._-_-_.__.------------_-=-� ` F%�T1NG No. of compartments----- ------- Size-----------------t------- -------Liquid depth--------------------------Capacity------- ! t ince from foundation__At_______ --_.Distance to nearest lot line__5_____-___.- g e� .Width of trench------3Q"---------------------- 4 Disposal Field: Number ofolineSeares�t w--1 C-=Denath of each line__----- t ' P ' -- t l; Type of filter material_,_-�jn-.�----Depth.of filter mater�al----lg ____-___v Total length________________ + Seepage Pit: Distance to nearest well_ __________________Distance from foundation_-____.___________.Distance.to nearest lot line___.____-_____-_- Li n in Depth--------------------------------- I ❑ Number of pits------------ g material-----------_-----------Size: Diameter--------------------- ��. Cesspool: Distance from nearest well-----------------Distance from 'foundation--------------------Lining material-------------------------.----------- ❑ Size: Diameter--------------------------------------Depth---------------- ----------- ------------------- -Liquid Capacity--------------------------- gals. s Priv Distance from nearest well------------------___------------------------ ---Distance from nearest building--____ ______--------_----------------- y --------- --------------------------------- -------- Distance to nearest lot line_-_______:____________ • ---•-----'------- ------------ Remodeling and/or repairing (describe)______________________________________________________ - -------------------••-----•----•-••------------ ---•------ ------• '• ---------••----------•--------•-•---------------------------------•---•------------------•--•----------------------------------------- -----•--------------- •----•-------------- I hereby certify-,that--l-have prepared th'i's 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. } iii N . ontractor) (Signed) _D - PARR=- i ----------------------------------------------------------- -----------------(Title)------1'�-- 1,XU-0R---------------------------- - sY i (Plot plan; ho ing size of lot, location of system ' relation to wells, buildings, etc., can be placed on reverse side). , FO APARTMENT USE ONLY APPLICATION ACCEPTED BY___________________ DATE----------- - ---- "-•t ""' DATE---- '; REVIEWEDBY--------------------------------------- ------------------------------------------------ DATE------------------------------------------------ - ------------------- WILDINGPERMIT ISSUED------------------------------------------ ----------------------------------------------------------- Alterations and/or recommendations----------------------------------=-------,.___ --- ---- ----- ---------------------------------= ------- ----•--------------------- 1 h_____-_ --_-_ _____ __ -__ __-_-___-- _____________ --------------------------- __-- __--_. ..�- - --��:----- ------------------- --------------------- ---- - I ----------- FiNAt INSPECTION 8Y______________ __ __{--- _- _- ------------ Date 7-�-f SAN JOAQUIN LOCAL-HEALTH DISTRICT 132 Sycamore Street 814 North "C" Street 130 South American Street 300 West Oak Street Y Lodi, California , Manteca, California Tracy, California Stockton, California E5-9-21VI 8-51 Revised W-2100