5588 - Laserfiche WebLink

Home Browse Search

\ APPLICATION FOR SANITATION PERMIT Permit No. _`-`^ _ in Duplicate) q (Complete P ) Date Issued9_�.;as._:__J_r_� 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. 549. Or'- the levee, , New 4ouse. JOB ADDRESS AND LOCATION_Atherton_ _ _ _ _ ____Cove, , left off_ 3600 Blk. Country Club-_Blvd. __________________ __ ------_ _ _ -. Dr. James Powell (Modern E-ngineers, ContAlne Ho- 2.3.772........... Name ----..... - ------------ .. m Add rase_________________ - ------------------------ P------------------------------------------------------------------------------------------------------------. ----------------------------------- Parrish Inc. HU 6g6Q7 Contractor's Name------------------------------------e----------------------------------------------------------------------------------------------------- Hu 6c)697 Installation will serve: Residence.'C] Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units:l---------Number of bedrooms __3... Number of baths 3----- Lot size -_1--- Pre__plus_,...................... Water Supply: Public system ❑ Community system ❑ Private [�: Depth to Water Table -------- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ] Hardpan ❑ Previous Application Made: Yes ❑ No In New Construction: Yes [21 No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.)f r 10 CC Brick Septic Tank: Distance from nearest w2eli.75-_--...-_--Dista p% from�f ooundation_____ ______. tgfial-----_..___-._-._ _ .-__--_----_-_------______- [4 No. of compartments___.._._______._.__._Size g,t---- eb-�, ----.....Liquid depth__��-_-_.______.-_-Capacity......I000 Ga Disposal Field: Distance from neare well-75-1_-__-_.-Distance from foundation-1'�_t.__-_-----Distance to nearest lot Z, 5 t y --------------- ]9f Number of lines---_-------- ��2 _ _ Length of each line___-___.90_r_____________Width of trench-_-.________--_____-_____._--_----- Type of filter material.. '_a-----------------Depth of filter material-__.1 1�_-__-__-_--Total length____180t___________________________ Seepage Pit: Distance to nearest well----------------------Distance from foundation....................Distance to nearest lot line----------------- El Number of pits______________________Lining material-._._._-_-____--__-.--.Size: Diameter--------------.-._...-_.Depth_--._---_.-._-._-___-----________ Cesspool: Distance from nearest well-----------------Distance from foundation------------.-------Lining material___.____-._-__-_____-_____-_-__-___-_. ❑ Size: Diameter-------------------------------------Depth.--------------------------------------------------Liquid Capacity..--------------------------gals. Privy: Distance from nearest well-------------------------------------------------Distance from nearest building_-__----_--__--__-____________.______-_-_. ❑ Distance to nearest lot line----------------------------------------------------------------------- ---------------------------------------------------------------------- Remodeling and/or repairing (describe):--------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- I hereby certify that I have prepared this application and that the work wjII be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. �(SPARR IS H I PJ igned)-------------------------------------------------- - ------�- --_.--- -------------------------- -----------04; Contractor � _ (Title) Estimator (Plot plan, showing size of lot, location(of system ' relation to wells, buildings,"etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-.___________ ____ _ DATE----------- L;_ _. REVIEWED BY-------------------------------------------- -- �---`J------------------------------------------------................. DATE----------------------------- �- ---------------- BUILDINGPERMIT ISSUED.................. - -......................................................---------------------- DATE-------------------------------------------................. Alterationsand/or recommendations------------------------------------------------------------------------------------ --------------------------------------------------------------------------- _------------ ----------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------.....---------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------- ----._...----......------------------------------------------------------------------------------------------------------- 2-1 FINAL INSPECTION BY----------------- -------------------------------------- Date.---------q----- 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 W-2100