8214 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No. , (Complete in Duplicate) ' - Date Issued ------I Application is hereby made to the San Jo u' Locafifealth District fora permit to construct and install the work herein described. This application is made in compliance ;Gn;`y�rdinance�No, 549. _•r JOB ADDRESS AND LO ATION------- --------- -.,,_�_ ---------------`------=------- Owner's T -------------- - ---------------------".-. Phone------------------------------------ -- - ---------•---------•------ Contractor's Name----------- " �"1f ' Tf- A------ --------------- Phone-" QS` Installation will serve: Residence � Apartment House ❑ Commercial ❑ Trailer Court ❑ Motef ❑ Other El Number of living units: .- -"_-. Number of bedrooms _--, Number of baths " Lot size - Water Supply: Public system Community system ❑ Private ❑ Depth to Water Table vft. Character of soil to a depth of 3 feet: Sand [] Gravel ❑ Sand Loam Cla Loam Clay Y ❑ Y ❑ y ❑ Adobe Hardpan ❑ Previous Application Made: Yes ❑ No New Construction: Yes [9--No_ ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public se `er is available within 200 feet.) + Septic Ta Distance from nearest well_- Distance from.foundation_.-__/.�----"_.Material-"----.- No. of com artments.._-" , p f!"."" -------- Size------- -EC�.3�------Liquid depth-----'� -- ; �---- Capac,tY1 �•. Disposal Field: Distance from neare t well-- f1+�r-Distance from foundat'on_"�0-- -"_-_-.--Distance to nearest lot I,n�f".-tEC "f• Number of lines----_ / _ C� Length of each line--_ , -_". "_ __- Width of trench--- �~ Type of filter material--:-_-- - it filter materia "./._ Total length 9 -J-�D---------------------- apt o Seepage Pit.: Distance to nearest / � -------D,stance�ram oundation". ±� Dista ce to nearest lot lin � L1� Number of pits.. Lining material------------ [ r — -------- --- ---..-Size: Diameter.-.. Cesspool: Distance from nearest well------------- ---Distance from foundation-_-.-----------------Lining material-- --------------------------------- El Size: Diameter = DepthI.,- Liquid Capacity -------- 9afs. Privy: Distance from nearest well----- "---___.- --__-_ .. Distance from nearest building------------•--------- ""-"_-"-. ❑ -" Distance to .nearest•lot line-----------------------------•--_-- . � �. - Remodeling and/or repairing (describe):------------------------------------- -------- -----------•--------------------------•-------- -------------------•----------•----------••-----------••------------------------••--------•----------------------•---------•--- -•--- --•-- -- - --- -- ----------- - ----- ---•-- -•---- --•- ------ -- ------- I hereby certify that 1-have-prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rule MYMWiffs of the San Joa in Lo I He Ith District. r (Signed)_ Septic Tonk.Sorvics T2II15"So:E@dio csc a HO-2-7th----------------- - "-"--- � (O7wner7-6w/o r Contractor) �a ------ . .. BY= fgc)Cton, Galt4. � , -- - --- ---- (Tale} {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 APPLICATION ACCEPTED BY------- -------_--------- ____ - ------------- --------------------- ------ DATE - _ REVIEWED BY - ------------------ --------------------------------------- DATE \' BUILDING PERMIT ISSUED---•----------•--------------- ------ -�- --------- •- �--------------------•--------...--------•�- ----------------- ----------------- -• --- DATE---- ------------- Alterations and/or recommendations: ---------------------------------------- \U ----- ----•-- ------- 0 --- -------------------•-. ""--_----------- ---"._ ." "-_.-"""" "F.." -. __--------------• -"__-- ---------_------------'--------------------------------------------- FINAL INSPECTION BY:--.----. -Itz_ ---- Date._----- 1/ A.4�------ ------------------------------ SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 S camore Street y 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES--•'g 145446 AT-VCD ,