10413 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITSANITATIONPERMIT PermitNo . ' ''I Y (Complete in Duplicate) O\ D�+o |�me6 __,___,___ / mu6n . the San Joaquin Local Health District for permit t000nstrinstall a||t6owor described. 6o�c, e6. T is application is made -in compliance with County Ordinance No. 549. ` | � """.=�__ '=��~=---------*~�~ ^ |��8� *� menm; ResidenceApartment � so F Commercial [] Trailer Court El Motel El Other El Number vfliving ' Number of m, -Z-mum6er of baths /-. Lot size ------' Water Supply: Public system Commun�ity system F1 Private M Depth to Wafer Table3NCff. Character of soil to a depth -� �`few+: Sand E] Gravel E] Sun6yLoam Clay Loam E] Clay [] Adobe H*n�pun E]Previous Application Made: Yu, MNn New Construction: Ye` N� [] PHA/VA. Yes [:] No 2� v TYPE OF INSTALLATION AND SPECIFICATIONS: '( ` ' (No septic tank or'cesspool permitted if.public sewer is availablewithin 200fn +J r-.S'' Tank: D�s+onco from nearest woU-- , Ditu � hfrom �fo�u�ndotion-W------------ T --- ~4o. ofcvmpo�men+s---- Z�- Si,v ~ .---.Copuci+y. � -._�?-~-- - D | ��6� Didnncv from nearest weU' -Dj�onuw from foun�o�on. Z�.,._'Di�ancv to nnuvos+ lot � �-_ Number of |�o� Length of each ��. of t� � Type 01 filter mafv�oL_.. Depth of filter material ./6---------------- |eno+h-,r4.------ SeePit: Distance to nearest well 6 _/j0_,_ nearest lotkn ' -- NNumber � pits.--.-/ ----�n�ng ��| ' � " °�' S�;' Diame��JS ��^a �------' _~o Cesspool: Distance from nearest well-----------------Distance from foundation - ----------- -----Lining mutvrioL-------------- [� Size: Diameter.--.-------------.--.Depth--------- -------------------------------------------Liquid Capacity_--------------------------gals, ~v | Privy: Dbf nce from nearest well-------------------------------------------------- from nearest building------------------------------------------ F1Distance to nearest lot line--------- ------------------------------------------------------------ -------------- ------------------------------------------------------ �� | `~| � - Rrmo6��y on�/or repairing (6ms �6u)�''--'''—''-��_'--_-'--_-'''--''__.--------_-.-''--_''-________-_ ---------------------------------------------------------------- --------- ------------------------------- --------------------------------------------------------------------------------------------------------------- --�-'-_.-'__.------. ----------------------------- / ''_-''_-__'-___-'-'---''-'�� .--.__-�----_-'------_.^__..___..---_..__.___.---_-__._-___—. I hereby certify that I haye prepared this aWicati and that the work will be done in accordance with San Joaquin County ordinances, State laws an egulati s of f San Joaquin Local Health District. (Plot plan, showing size of lot, location of system in relation to w s, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY ` ` ^rruCx//um ACCEPTED B. / --_-_'---.--'-_--_---_---_-----._--_-- ----_---,---.--..,-_---_-___.-_._.__._- / —'---''---'''''---.-'--'--''--`''---'-- -----------------------------''��---------- ---------------------------------------------------------------------------- ---------------------- ._----.--------------------------------------------------- . -------._----_--------._---------_._---.. . / �? FINAL INSPECTION BY�. !? Do+=../-.��..�/ �� ------ _-_-_'— ' y SAN JOAQU|NLOCAL HEALTH DISTRICT /30 south Arnerl*a"Street 30D West Oak street /32 Sycamore street ow North "C" street Stockton, California Lodi, California wm"*"", California n="v. California ' es-q-2w . x*.is°a 1.57 p,v.Co. .