13308 - Laserfiche WebLink

Home Browse Search

7/7 � APPLICATION FOR SANITATION PERMIT Permit No. _-_l .3d_: .•� � ('� (Complete in Duplicate) S This Permit Expires 1 Year From Date Issued Date Issued -___ ..... 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---- 5-04k--Anteros-------_._ Q_Ckton--------------------------------------------------------•------------------- Owner's Name...... ATICS----rs-` ...Batton-------------•--------------------------------------------------------------------------------•---- Phone..HQ---35Q60---------- Address------------------5.ZQ--jS_O... &nte_rO-S------------------------------•-------------------------------------------------------------------------------------------------------------------- Contractor's Name----The-_D.AY..&._NIS`zHT_S_.-._T......Svc.--------------------------------------------------------------- Phone..... ... Installation will serve: ResidenceU Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: AL__ Number of bedrooms __2___ Number of baths ---1-- Lot size ---------6Q1....X_._la5----__-_____.__-__-___-- Water Supply: Public system =Community system ❑ Private ❑ Depth to Water Table ..6.0 ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe Mt Hardpan ❑ Previous Application Made: Yes ❑ No ❑ New Construction: Yes ❑ No M FHA/VA: Yes ❑ No ❑ 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—R011e_-----Distance from foundation . oundat ion.....__.a-Q-i------Material------CC -Rr �C ---_-------------- JIM • No. of compartments__-_-_____-2--__-__-_---Size_566fLiquid depth____-____ 811. Capacity $00... Gals x de-epiiDisposal Field: Distance from nearest well HQnC vistace m foundation t._.__...Distance to nearest lot line___�__._______. Exi3ting Number of lines-_------------ --------L"gfh of each line___ 0'.__ZO ....... of trench------- 4----------------------- & _____-___ _ _& ADD Type of filter ma+eri61___5eP`0 RkDepth of filter material_ 1$1t Total length_.6Q!___—alis ting._301 total 0 Seepage Pit: Distance to nearest well_ NQnC---------Distance from foundation___-- 0---.......Distance to nearest lot line-t_5--r ........ [IX Number of pits------------1------_Lining malterial....ROCk------Size: Diameter------33_- ........Depth----------25..______ ...... Cesspool: Distance from nearest well-------_---------Distance from foundation--------------------Lining material__--_---._.___-____-__-__-_____-__-__. Size: Diameter--------------------------------- _De th-_.______---_______________ _ _ __________Liquid Capacity gals. Privy: Distance from nearest well _._- -------------------------------------------Distance from nearest building-.-----._______-_--_-_.----•----.____-_-_. ❑ Distance to nearest lot I line---------------- -------_------------------------------------------•------------•• -----•--------------------- . * Remodeling and/or repairing (describe).*___.enlacing_..p_S?x'tiQn...S?f...e.Yidting----5ys.t_ftCA.._........................................ ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ ---------------- ------------------------ --------------------------------------------------------------------------------------------------------------------------------------------------•------------------------------ ------------------------------------------------------------------------------------------------ ---------------------------------------------------------------------------------------------------------------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. (Signed)-Tl4._DA &__X10HT--- pt3c---Tank---$-e vi-c-e- -- --------- ---- --------------------------------(�irX�Contractor) By:------------------------------------------------------------------------------------------------ Title)-------------------------- (Plot plan, showing size of lot, location of system in relation tow , buildings, etc. can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY..-'.- --- -------- --- --- -------------------------------------------•- DATE----------- REVIEWEDBY.-----_---------------------- -------------------------------------------------------------------------------------- DATE------------------- BUILDINGPERMIT ISSUED-----_--------_---------------------------------------------------------------------------------- DATE------------------------------------------------------------ Alterations and/or recommendations:---------------------------------------------------------------- ----- -- -- -------------- ----- ----------------- ----------------- --------------- --- .. - �s y- ---------------------------------------------------•------ --- ------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------- ---- ------------------ -------------------------.--------- ------------------------------------ ----------------- ------------- ---- _...------------------------------------------------------------------------------------------ FINAL INSPECTION BY:--- -- 1 ,--------------------------- Date------= ---- ----- -- -------------- --- --------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2M Revised 8-'59 F.P.Co.