13131 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: ` _________ r ..� R� -� -- "------ -----" --------- APPLICATION FOR SANITATION PERMIT Permit No. --__ ` = ------------------- o- ------------------------------- ------ (Complete in Duplicate) Date Issued "�.k------••Q{ -------------------------- This Per Expires 1 Year From Date Issued .—o404,3 Application is hereby made to the San Joaquin Local Healfh District for a permit to construct and install the work herein described. This application is made in_compliance.. ith County Ordinance No. 549. /r/U(Gi h � O,�j ----� --------------'= A-DD'RESS AN.TLOCATION-------------- - -- ---------- f / Phone------•---------•------------------- , Owner's Nam -__- Address---_------•• --•------- -----------------------------------------------------'----___---- oPhne - Contractor's Name _____. Installation will serve: Residence [��Apartment House ❑ Commercial ❑ Trailer Cour# C] Motel [3Other ❑ Number of living units: ___t___ Number of bedrooms ___r " Number of baths .. tot size ___ $ 'l_1-s---------•-•--------•-- Water Supply: Public system Community system ❑ Private ❑ Depth to Water Table -------- ft. } Hardpan 1. Character of soil to a depth of 3 feet: Sand E] Grave! ❑ Sandy Loam ❑ Clay Loam ❑ Clay []—Adobe❑ [I I� Previous Application Made: (if yes,date____________________} No New Construction: Yes ❑—No ❑ FHA/VA: Yes E] No [�}-� f TYPE OF INSTALLATION AND SPECIFICATIONS: 1 (No septic tank or cesspool permitted if public sewer is available within 200 fee4.l r Septic T nk: Distance from nearest well 4 _t'_____Distance from foundation__/p___�__�___.Material___�l4L'_�" -(.P--- -- �'� No. of compartments_---- _._-- -!' *.��------Liquid depth--_-__-4 ------•----.Ca aci Size P tY - ------•r� pis osal field: Distance from nearest well-_rn�»(."Distance from foundation..l�--r ---------Distance to nearest lot line-Lf------------ 7VNumber of lines-------t3-----------------------Length of each line-----9'17---r--------------Width of trench----------- --------------- 1 #h of filter material__1S-----------------Total length---�-kd--------------------------- Type of filter material___" -----.--Depth :.�•e.,.�r-.a,yew.� sir l Seepage Pit: Distance to nearest well-------------------_-Distance from foundation----------------------Distance to nearest lot line.......... ❑ ��I .Number of pits-----------------=----Lining material----------------•-----.size: Diameter----------- -----Depth------------------ ------ ..: Cesspool: Distance from. nearest well__��_--_______Distance from foundation _..."_______________Lining material________:.._______________.__.____. Size: ,Diameter"------------'"'" --------------- Depth-------------- ----- ------------ ----•--- Liquid Capacity. gals, Priv Distance from nearest well--------------------------------------- 'from nearest building_____._--__________----------------•----- y:: -- ------- --- --------- ' ❑ Distance to nearest lot line --------------- ------ ------------•------------•----::._..-------_-•-•-;»•------- - Remodelingand/or repairing describe -------------•-•-----------------------------••---------=-------------•.•-----•.•--------- ----------••--•---•----Y-�-------...----------••----•-------• / A 9 � } ----- --•-•---------------•----- --- 7----------- --------- ------•--------------- i r -------------------•--- -------------------------------------------------------•----------------•"-----------=---------------`----------------------•------- --------------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County i ordinances, State laws, and rules and regulations of he San Joaquin Local Health District. (Owner and/or Contractor (Signed)-------------------- = /' -------- -- --------------- - --------------------------------------------------- 1 -•------------ - (Plot plan, showing size of lot, location o system in rel ion to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY -------------------------- 'APPLICATION ACCEPTED ........ --------- - ----------- --- DATE------� REVIEWEDBY----------------- "'-------- ----------- DATE------------------------------------------------------------ BUILDING PERMIT S -------------- DATE------------------------------------------------------ Alterations and/o recommendations- .._Boa----aa(- ----TJ� "�� - ��"u��- � AV 1 : 200----- -(—yJ ------__`�.ANK----•I�l��—., �...�1�_1�� ----------------- --------------------------------------------------------- ------_ --- - -•----- ------- - --------- - - -------- ----------------------------- -- ---------------.----------."--------•----------------- IL : f , s FINAL INSP - - - -- - --- ------------ --------- --- - ------ Date. SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California [B-9 REvmE0&•59'F.P.0 d.2m&.Ito r,