11849 - Laserfiche WebLink

Home Browse Search

s j - APPLICATION FOR SANITATION PERMIT Permit No. ..... � j..11 . (Complete in Duplicate) o-` d` This Permit Expires 1 Year From Date Issued Date Issued . Y._�t ) Application 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..549: JOB ADDRESS AND LOCATION---• I- .-�Y►..--xll[llaiosl-'w..__ka-40-f------------------------........... •--•- Owner's Name.... ...... 141'"I��lrr2-Gt -------W-------4a4ft-A7._a_!---------------------------------------------------. Phone._6.j?.,T!!?_�3#.. Address ----................... �1�.7 tq.(_Illi!HrA_ ?!!�..._..•.......> G. Q: -------................................................. Contractor's Name-----------------------------------------&W.At.&J----------------------------------------------------------• ------------ Phone..................................... Installation will serve: Residence S) Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: J..__ Number of bedrooms Z. plumber of'baths'.J.... Lot size ------LFACJ-'"A .......... .................... Water Supply: FPublic system ❑ Community system 0 --Private K Depth to'Water Table 3A ft. Character of soil to a depth of 3 feet: .Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay Q Adobe❑ Hardpan Previous Application Made: Yes ❑ No 1Z New Construction': Yes ❑ No 8 FHA/VA: Yes ❑ No K TYPE OF INSTALLATION AND SPECIFICATIONS. (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well -71.5-� -Distance from Foundation'...j.Z.........Material 144W.--Q4041 No. of compartments____-7_4---------'Srze..l -X$..?�. �__--Liquid depth........16--------------Capacity............__...--•_ .. ♦ 10Disposal Field: Distance from nearest well1,SQ Distance from foundation Q i Distance to nearest lot line , A '# Number of lines-_ -•-/_____.___. Length of eachi line _-------- Width of trench Type of filter material_________________ Depth of filter material. Total length....._........_........................... Seepage Pit: Distance to nearest well----------------------Distance from foundation....................Distance to nearest lot line ❑ Number of pits......................Lining material-_------------------Size: Diameter------- ------Depth .._--•---- ••.-- --------- Cesspool• Distance from nearest well _Distance from foundation--------------------Lining material-. ........................... - --Size.-Diameter Dep#h•.. �.r_ .p-._ d-Capes« .rte .gals — Privy: Distance from nearest well....... .......... ........ ...............Distance from nearest{vildmg............................................ ❑ Distance to nearest lot line------------.--•--• ----- ••--1.-----•... •---- -•--••--- .......... ---•-} --.........- , , 1. . ' �' r s........Rem elng and/or repairing (describe):_..__.4 � n ----- ---------------V)--- ---------- --- -- -------- - ---•-----------------•------•--------------------------------------------------------- • •---•- •----- -•------- --------- -----••. --•--•. ----•-• ••--.-_.. -••••••• --•-•--•..----••--• ••••• - -- -• -•---•.... ... ... .. -•------ hereby certify that I have prepared this application and that the work will be done in acpordence with San Joaquin'County ordinances, States, and rules and, ons of #fm San Joacn Local, Health District. _. ._ , !! ... _________ _________ ___Owner and/or Contractor (Sigma) i ( / I --- By: -------------- --------------------------------------------------------- ------ - - -------•--- ITtle (Plot plan, showing size of lot, location of system in relation to wells,buildings, silo., can W on reverse side), FOR DEPARTMENT USE ONLY o , APPLICATION ACCEPTED BY.j3, ..... -- --------------------------------------- DATE....... --- '=-7- -- REVIEWED BY------------- ------ DATE........................................................... _ BUILDING PERMIT ISSUED.............................................................. ----•-• •-.-..- DATE. Alterations and/or recommendations:........................................... -. x...... .......................... 1 . ................................................................. ......................... FINAL INSPECTION BY------ ----- ---- --_.. .. ...... ..... __.--- ! Date..__._/y_1 �G-------------------------------------------------- SA JOAQUIN LOCAL HEALTH DISTRI 430 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteea Califarhia Tracy, California ES-9-2M Revised 8-'59 F.P.Co.