6160 - Laserfiche WebLink

Home Browse Search

1� ^11 APPLICATION FOR SANITATION PERMIT Permit No. .- -/($ a= f (Complete in Duplica+e) /y 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. 544. --------------- --•-----•-------------•---------------- JOB ADDRESS AND LOCATIO ._.---113_---- - � �" ��//� 77 ----- ------------------ = Phone��T6-- 2 � ------ Owner's Name_ �t_�5.-------�-- -�`-f`"------ -•-----------------••---- ----------- - - Address...--- ------••------- , _._`r - ,.-r ---------------------------------------------------------------------------•------------------...------- Contractor's Name---------- ----------------------- ------------- -------------------------------------- -----..-... Phone----------------------- ----------- Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ___t_ Number of bedrooms . ___- Number of baths _------- Lot size --> a--` :__.t_5—.4__ Water Supply: Public system [Community system ❑ Private ❑ Depth to Water Table.© ft. # Character of soil to a depth of 3 feet: Sand Gravel ❑ Sandy Lo;�PNO Clay Loam [D Clay E] Adobe Hardpan ❑ PP Previous Application Made, Yes El No New Construction-. Yes E] TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) ,,FF ..---..._.Material__._------------------------------�------------- Septic nk: Distance from nearest wellp"�-4�Distance,�m foun`dation__t�.'�_ _ �+ �. ( '�' Liquid depth +ate -- --------Capacity--��--------- No. of compartments_.:Y---------------- ----Size_. �4 ,r A- 31, ` r� `Y Disposal field: Distance from neargst well--1�-�Distance" rom ou ation__. ----Distance to nearest lot line._4_1 p _-_ T Number o; lines____f------.....j__-----.- - __Length of each line_��--- ---------- of trench._ --- - f��U De th of filter material_--�-�`--------.Total length--/f"---------------•------------ Type of filter material___ .-------.j-- p Seepage Pit: Distance to nearest well_AY.( frcon fo ndation__„�r--.-.Distance to nearest lot line-----._ —� Y) _ Size: Diameter__. .......- Depth_----�- ------ {� LS �_� Number of pits---------------- ---Lining ,material-� _.-___-- -- - ---- Cesspool: Distance from nearest well-----------t-------Distance from foundation-------------- =----Lining material--------------------------___--------- r ❑ Size: Diameter --------- Depth:__"---------- '-------------'Liquid Capacity---------------------------gals. Privy: Distance from nearest well--------------------------- --------------------mance from nearest bui ing.------------------------------•---------- ❑ Distance to nearest lot-----------------------p--------------: in ------------------ ------•--------•------------------------------------------------------------------ f Remodeling and/or rep`amng�{d`escri4�e�:____ -- � -- -------- --------- -•------••-------•----------•---------------------------------------•----------------------------- ----A---------------•--- - -------- -----------------------•- -------------------- •---------- ---------------------•--------------••--------------------------------------------------------------- I hereby c that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, S+ to la s, and rules a regulations of the San aquin Local Health District. [Signed}.... - Contract -------- -------------------- U714 in 9F and or or} i- By:--•------------------ ----- - - -------•------•------ •----[Title}__._� -- - - -- �- ---- -------- --- -- (Plot plan, showing size of lot, location of system in relat' to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY _iJ APPLICATION ACCEPTED BY---------- ------- --- -- ------------- ---------- DATE ✓ REVIEWEDBY----------------------------------------- -------------- DATE------ -------•------------------------•------------ BUILDING PERMIT 155UED------- ---"------------------------------------- DATE---------------•------------------ •------------- ---------- -------------------------- Alterations and/or recommendations:------------------------------ - ••---------..-..------• --•----------------------- --------------------•--------------------••------------------....-------•--- ------------------------------------------------------------------------------------- -------------------------------------- -------- -------- •------ ----------- ------------------ ---•-----------,`�— Date_. --- - -------------•------•-•---- FINAL INSPECTION BY----------------------A I _ _ SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Man# California Tracy, California r E5'-9-2M 195446 ATWDOP 12-54 _ _