10281 - Laserfiche WebLink

Home Browse Search

i ' Permit Na. ��- ," APPLICAT16N FOR SANITATION PERMIT 1 g (Complete in Duplicate) Date Issued __�_�1_�- is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. Applicationy This application is made in compliar�ce with County Ordinance No. 549. d ------------ -------------- �dp ---- JOB ADDRESS AND LOCATION---------- -- :----. Phone----- a?' x I =----------------- -------- -------------------------- 11�' 4vt - Owners ..Name__ _ __ _ Address-� , -------------------- • ---------------- ----Phone ---•-------•---- ' ------------ Contractor's Name --i _ Motel ❑ Other ❑ Installation will server Residence ApartmentiHouse ❑ Commercial ❑ Trailer Court ❑ I Number of living units: __ �____ Number of bedrooms_Z Number of baths �__ Lot size ------ ---- Private ®,,Depth to Water Table3_�-: ft. Water Supply: Public system ❑ Community sysfem ❑� � Adobe Hardpan ❑ Character of soil to a depth of 3 feet: Sand ❑ Gravel [] Sandy Loam[]" ' Clay Loam Clay ❑ ❑ Previous Application Made: Yes ❑ Nog New Construction-` Ye��'�Fi No ❑ FHA/VA: Yes ❑ No ❑ _ TYPE OF INSTALLATION AND SPECIFICATIONS: .: ' �,�--.�,..:W[No-septic tank`or=cesspool-permitted-if`public=sewer4s available-within-200•feet.) ---------------------- v Capacity -- ql?---------- Materia -- p -------- Liquid de •th------- P Y No. of compartments - , Septic Tank: Distance from nearest well_____ �-.__ --__ Distance fromfoundation �� osal-Field: Distance from nearest well_________________`Distance from foundafion_' 1.�___-__._.Distance to nearest lot line.4_1.----•--� � C� Disp Width of trench ".± Ib ' Number of lines___________ _ ----------Length of each line____�6 Q-------- 1 Total len th_---- �0 -- ------ v, De th of filter material_ -_-J-'%------- ---- g Type of filter material- p Seepage Pit: r Distance to nearest well___i_�_6-`------Distance fro foundation___.__'___. ---.Distance to nearest lot line ... Number of pits__ _ __.__Lining material__.__r--4-- ----- Size: Diorpeter---�3��--------- Depth_ _ '� C = -------- Cesspool: Distance from nearest well ------------------ Distance from foundation ---------------------------- material___.__.______-_____--____---_____ De th-------------------------------------- Liquid Capacity _._.. - Sols. ❑ Size: Diameter-------- ----------------,- ' 4 p - - - :1 `mak Qistance from ne'&6_t building------------------------ . Distance=from nearest well--------------~----- F= - = --'-- =- Privy: ,..--r- ------------------------------------------------------ ---- k Distance to nearest lot ine_~'_---=--'=-=-,---- - ------------------------- El ti .. -------------- Remadeiingo_repairing �descnbe]____________________ ,_- _:1 and� L _ -----------------------•-------------- •- ---------------------- •---•- --- 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 rakes and regulations of the San Joaquin Local Health District. `�'� �--------------------------------------------------------- ---------------------------- --- -------------------------- (Owner and/orContractor) itl ]-="-"-,--- - ---------------- ped --- ---- -- --- --------- ------ --- _ (T' e oi+ (Plat pian,' -h-. _.owing iiia of lot, location of system in relation to wells, buildings, etc., can 6e placed on reverse side). FOR -DEPARTMENT USE ONLY ` - -----------------=-------- DATE---ll'#_"'t{•H ----------------------------- APPLICATION ACCEPTED BY._, } _. -_- DATE REVIEWED BY --------------------------- y:,---------:--.------. ------------------------- .. �---------------•------------. DATE---------=------------------------------------------------ BUILDING ----�------- ----------------• BUlLD1NG PERMIT ISSUED-__ ------=--------------------- ------------- --------------- -------------------- Alterations and/or recommendations:- , #-_--------------------------------------- ------------------- ----------------------------------- ---•------- --- "�---------- --------- •-- ------ ---------------- �" b ~ _ ----- -------- -- --- ----------- =.. ---------- FINAL INSPECTION . BY ----------- ------------ ---------------- -------------- �=----- Date-------------------------------•--------------------------- 130 South American Street Stockton, California ES -9-2 M Revised 1.57 F-R,CO. r SAN JOAQUIN LOCAL HEALTH DISTRICT 300 West Oak Street ti Lodi, -California 132 Sycamore Street Manteca, California 814 North ?"C" Street Tracy, California