Laserfiche WebLink
0/// . <br /> APPLICATION FOR SANITATION PERMIT 1 <br /> (Complete in Duplicate) <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> ttc Fav _<;,t- - ^ k <br /> JOB ADDRESS AND LOC TION____. - ----- ----- <br /> ---------- -------------- <br /> am a_ _4 --- ------- <br /> Owner's N -1 --- L.0 - --- ------- -- ---- <br /> ----------------------------------------------------- <br /> '0C <br /> - 4- ----T -------------- ---- <br /> Address --------- ---- <br /> J ------------ ---- ------- ------ <br /> Contractor's Name----- ------------- ...... ----------------- - ----- Ir------------------------------------------------------Phone--------------------- <br /> ---------------- -------- <br /> Installation will serve: Residence,s i d-,eon-c ieS Apar enf House [] Commercial Ej Trailer Court L] Motel ❑ Other E] <br /> Number of livtingunits: /Number of bedroomsljp Number of baths tot size----3q_0----A'__ 1,0------------------------- <br /> Water Supply: Public system E] Community system L] Private X <br /> Character of soil to a depth of 3 feet: Sand E] Gravel [] Sandy Loam E] Clay Loam El Clay [_1 Adobe 1ardpan <br /> ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well---- ___Distance from foundation----- ferial ----------------- <br /> ----------------- <br /> u depth--- <br /> No. of compartments--------I-------------Capacity-.---Z)-0-0---Size_______ ---- Liq i d <br /> Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material------------------------- ----_9 <br /> ❑ <br /> aterial----------------------- -------- <br /> ElSize: Diameter--------------------------------------Depth---------------------------------------------------- <br /> Privy: Distance from nearest well-------------------------------------------------Distance from nearest building---------------------------------------4: <br /> F-1 Distance to nearest lot line________________________________________-------- <br /> Seepage Pit: Distance to nearest well----------------------Distance from foundation--------------------Distance to nearest lot line_____________-) <br /> El Number of pits----------------------Lining material--------_------------Size: Diameter-----------------.-----Depth------------------------------ <br /> I <br /> j <br /> Disposal Field: Distance from nearest well----5�6_/..Disfance from foundation------LO----- Distanc,e.to nearest-lot-line <br /> Number of lines___________ ---------- Length of each line_________ Width of trench------------ -----On- ------ <br /> Type of filter materiarr <br /> 0 - ____S-1--' `' Depth of filter maferia1_____/_7--------- <br /> Remodeling and/jr repairin ( escribe)- /,'- -2�-J, J!!� .4 _L_ <br /> -_,5, W, � - - - ---------C.,- <br /> ----------------------------- - - ------------- <br /> ------------C.A_%Aelc�_ IL --------------------------------------------------------------------------------------- <br /> -------------------------------------- ------------------------ ---------------------------------------------------------------------------------- <br /> ------------------------------ 31------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> I hereby certify that I h�a a-p;repa . -Wit'application and that the work will be done in accordance with San Joaquin County <br /> ordlinanzeSfa 'laws, a d ru seand regulations of the San Joaquin cf. <br /> I W e <br /> (Signed)--- ----- - ----- -.4 ntracto <br /> - -------- --- -------------------------------------------------------------------------------------------------------------------(Owner and/or Co r) <br /> By:------------------------------------------------------------------------------------------------------------------------------------(Title)---------------------------------------------------------------- <br /> (Plot plans, showing size of]of, location of system in relation to wells, buildings, etc., must be filed with this application). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATIONACCEPTED BY--------------------------------------------------------- ----------7----------------------------- DATE-------------------- - - ------------------- <br /> REVIEWEDBY----------------------------------------------------------------------------------- - -- ---------- --------------------- DATE----- - -- - ----------------- <br /> BUILDING PERMIT ISSUED------------------------------------------- ----- ---------•-•-----•-- <br /> ---------------- DATE 3-------------------------------------------------- <br /> P <br /> _3 Alterations and/or recommendations:----------------------------- --- ---- -- -------------------------­----------------------•-----•----------------------------------------------- <br /> ---------------------------------------------------------------------- <br /> ---------------11------------------------------------------------------------------- -------------------------------------------------------- <br /> -------------------------------­­­------------------------------------------------------------------------------------------------------------------- --------------------------------I---------------------------- <br /> -----------------------------------------------------------------------------I---------------------------------------------------------------------------------------- ---------------------------------------- <br /> ---------------------------------I----------------------------------------------------------------------------- ------------------------------------------------------N-------='K, ------------1--1------ <br /> //,, <br /> _, _PERMIT No.__? 5_/4 Date------------- � ------------------------------ <br /> - <br /> ------------------------------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street <br /> Stockton, California <br /> ES-9-2M 9.50 Wd639 <br />