8259 - Laserfiche WebLink

Home Browse Search

APPLICATION FOS_ SANITATION PERMIT Permit No. (Complete in Duplicate) Date Issued !- Applica+ion is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. mile W of Tre.cy_ an Highway #]D - to the Streetcar JOB --ADDRESS AND LOCATION--------------turn ..S -- .- ----t -------a ----------------------------- ---- --------- Owner's Name..Da�'g�a�__H�:�ki7�Y_•_turn left dust this side o the �'Cr etcar and it is the •-hOu�e__.o-ri__-tlr.e r�:�;ht----e-ide;-- - hone-------Te:----5-422 Address-----RI.,----14--_3-g-�__-691,----•---------------------- Contractor's Name-----------------------Delta HO. 3-�-12�g ------------------------=-------------------------------------------------•------------------------------------------- Phone.. Installation will serve: Residence [k Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: _1--- Number of bedrooms ..2___ Number of baths I______ Lot size .-._-3---99-re8 Water Supply: Public system ❑ Community system ❑ Private E4 Depth to Water Table _8Q_ ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe® Hardpan ❑ Previous Application Made: Yes ® No ❑ New Construction: Yes [3 No ❑ TYPE OF INSTALLATION AND.SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well__.-59_1------Distance from-fQundafion_ .____._._._.Material c. cement No. ocompartmentsSizetI vy 3 _ -------2 -----------'-----------Liquid depth-----}- ---------.Capacity----- -- -t-------- � Disposal Field: Distance from nearest weli----.--5.0_t.._Distance from foundation----1..Qt--------Distance to nearest lot line.--.- --------- Number of lines--------------------- 1----------Length of each line-----------.�-Q------------Width of trench----------21------------ ------ Type of filter material___ ! i 811 �,r�'_C,3_C�._ .Depth of filter material-- -�----------- -- length----____-- = .. ------_--- -____-- 40 Seepage Pit: Distance to nearest we--I S.'�. Distance from foundlti ______.Distance to nearest lot line_____.___S_____ [a Number of pits-------.1-----------Lining material----brl.CX____Size: Diameter---33..............Depth____x.5----------------------- Cesspool: . Distance from nearest well-----------------Distance from foundation--------------------Lining material------------_____.__._____________--_ ❑ Size: Diameter--------------------- ---- ----------Depth----------------------------------------------------Liquid Capacity----------------------------gals. Privy: Distance from nearest well-___------____-----------------------------------Distance from nearest building____.-____._________________________.___. ❑ Distance to nearest lot line------------------- -- ------•------------------•--------------------------•------------------------------------------------------------- Remodeling and/or repairing (describe):--------I1 W---PXPlgm--- -i dY'-_Old-_hOIl1G--- •-•--------------•---------------•-- -------------------------------------•-• -------------------------------•------------------•------------------------ •--------------------------------------•--------------------------- ---------•------------•-----------------------------I_--------------------------------------------------------•---------------------•------------------------------------•---------- ------------- ------------- ------ --------------------------- - 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)-------------------D-el-ta---S_en.tA_c___Tank -'S_erVJ 0.e--------------------••------------------ ---------------------------(Owner and/or Contractor) Gen. I~+`.gr, By:------------------------- er'rylarthan.-__---------------------------------------------- Ir#le)--------------------- (Plot plan, showing size of to+, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY - ------------------------ DATE `� - REVIEWEDBY l- --------------------------------- DATE --�----------- ----- ------ r BUILDING PERMIT ISSUED------------------------------------- - DATE. Alterations and/or recommendations------------- --------------- ------••----•------•------------- -------•-----------------------•-------------------- ---------------------------------------'---- ------------------------------------------------------------------------------------------•--------- -------•-•--------------- i _______________________________________________________________________ ______r__.___._..______------___.__._____________..._.._____.-----.._-____..____-_________.._..____.---__-__.-____.____________________-__.-•-_- FINAL INSPECTION $Y------------------------ • ---------------------------------- Date--- -------------- ------ -------------- ----------•--------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California f E5-9-2M 145446 PTWCOD 12-54 '