21732 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: --- ----- _ APPLICATION FOR SANITATION PERMIT Permit Na F1 ----- - ..------------------------- -- --------- --- ---------- �l- (complete! Cl ' ' ate) i Date Issued ------_-----"__...._-_ This Permit Expires 1 Year From Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to constructand install the work herein described. 2� �% r compliant ,with County Ordinance No. 549. This application. ation is made - - I JOB ADDRESS AND LOCATION.,......t- --------- ---el----�CA_49ew-------fi Z 7 ------ �?jRd - . .;2Owners me--- c --------•---•----------••------------------------------------------ --------- -------------- Phone 91 �'-----••--------�}�-�� -�--•-----------•-•--------•-•---------------•----•--------•------ . . --------------------------------- Address_� � n ` ArG�Q Contractor's Name-- -P --- � -------------------------------- -- Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ 11400 Number of living units: _�-----!Number of bedrooms _;�--.- Number of baths A.__ Lot siz ---------- �' Water Supply: Public system El Community system El Private �epth to Water Table ___..__- ft. alpth of 3 feet: Sand ❑ Gravel [ISandy'Loam-2}�Clay Loam ❑ Clay ❑ Adobe ❑ Hardpan C]Previous Character soil to a d dpplication Me. (If yes,date--------------------) No [!�' New Construction: Yes 2� IVO ❑ FHA/VA: Yes R— No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) :6 c ." ,� -Material P- � i Septic Tank: Dist�nce from nearest well_5f _t___Distance from foundation______ _ _ __ No.�'of compartments--------- ------Size--- f U---------------Liquid depth---_-y' ------Capacity--_� � ------- Disposal Feld: Distance from nearest weir_-�------Distance from foundation--------------------Distance to nearest lot line---07 ------- Number oflines----------I----------------------Lenh of each line.-------7 - -------.Width oftrench-----o \ ----------------------- I e of filter material---RDcA----._.---Depgtth of filter material----- -- ----_-.Total length---.--l--5^--- ------------------------- , f Seepage Pit: Distance to nearest well.__��_ Distance from foundation------ -----------. stance to nearest lot line__._5---- ---_ [� Number of pits---I - --------------Lining material-_ ri!-k -----Size: Diameter._421_K---------Depth----.4a--------------------- Cesspool: ------------------- Cesspool: Distance from .nearest well-----------------Distance from foundation------------ --._.Lining material------------------------------------- Capacity . � ❑ 5ize�: Diameters--------------------------- --------Depth --------------- - -------- -----------.--------Li quid Ca p Y----� -----------==---.-.- gals. 'l ---_.-Distance from nearest building ` Privy: Distance from nearest well-- ----- ------------`--------- -__ ----------' ---------•-------- ------ ❑ Distance to nearest lot line------------------------- - ---------------- ------- -------------------------------•----- ------------------------------------------------- - -- - Remodeling and/or repairing (describe):-------- - •----------- --------------------------------------------------------------------------------------------=---------------- ------------- -- I ,. ------ I� •---------------------------------------- --'•--------------------- Y a -------------- x i. , y + --------------- ----- - - --- --i------------------ ------------------------------------------------------------------------- i I hereby certify th"at I haveprepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws,l�iand rules and regulations of the San Joaquin Local Health.District. I L # (Signed):--:___--- - I � ~--;---------------i- ----- ----.(Owner and/or Contractor) . -' ° le By:----- - - -------- --------- ------ -----=----------- ----------------- -----(Tit }. -- -�--- -- ---- ------- .. ---------- (Plot plan, showing size�o lot, location of system in relation to wells-buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY - = ------------------- DATE----- `� / -------------------- REVIEWEDBY------------ 1-1---- ---------------- ----- ----------`.-.-------- ----------------- = DATE BUILDING PERMIT ISSUED-----------=-------------------------'- .------------------------------------------------------------- --_-------------------------- I Alterations and/or recommendations-------------------- ----------`--•-----•------------------- --------=------ S II ------------------------- ------------------------------------ ------------------------------------------------------------------------------------- II I I ,/ ..X T F �� Date----- --�- �--�--�------------ -------------------- FINAL INSPECTION BY:..._ ....'e_d_.-...`It e--- -- �� y SAN JOAQUIN LOCAL HEALTH DISTRICT i 1601 E.Haselton Avr. 300 West Oak Street 124 Sycamore Street 205 West 91h Street F Slotkton,Callf;mia Lodi,California Manteca,California Tracy,California i.� F.P.CO.