71-344 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: ---------------------- APPLICATION FOR SANITATION PERMIT (Complete in Triplicate) Permit No. _ ?�` 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 and existing Rules and Regulations: JOB ADDRESS/LOCATION ._________BACON ISLAND, CAMP 8 _CENSUS TRACT _____________._.______ -------- --------------------------------------- Owner's Name --IiTIEY-.FARM------------------------------------------------------------- ---------------------- -----Phone _HO 4-7944 ------------ Address ______41$_____S_,_-STANISLAIIS- STREET Cit STOCKTONt CALIFORNIA Contractor's Name SEL '- -----------------------------------------------•- ------.License # ----------------------`'Phone ------------------------------ Installation will serve: Residence ❑Apartment House❑ Commercial ❑Trailer Court ;❑ Motel ❑Other ---1_FAMILY LAB-OR DWELLING -- ------- Number of living units:_-__�------ Number of bedrooms -2--------- Grinder ------- Lot Size ----.--______-__.________.________.__ Water Supply: Public System and name _______-_.______------------------ -- -- - --------------------- -----------------------------'--'------ -------Private Pq Character of soil to a depth of 3 feet: Sand❑ Silt❑ Clay ElPeat[j Sandy Loam ❑ Clay Loam ❑ Hardpan ❑ Adobe ❑ Fill Material ------------ If yes, type __-___-__________.__-___ (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side.) NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) PACKAGE TREATMENT [ ] SEPTIC TANK{' t '___X t] Size---6-----$--8-- --6------- -------- Liquid Depth -------'4-t------ --------- Capacity --12QQ-__ga�ype -_CONCRET]AAaterial___-00-N-�RRETENo. Compartments _.___2_________ ____ Distance to nearest: Well• ------8Q01--------------------Foundation _____25f--------- Prop. Line __ — LEACHING LINE [ ] No. of Lines ------2---------------- Length of each line------ 80_x--------------- Total Length --------------- 'D' Box _________ Type Filter Material _91 ---Depth Filter Material ________ 3 t Distance to nearest: Well ------800-t-------- Foundation ______25_t _ Property Line - ------- --- ----------------- - SEEPAGE PITDepth -------------------- Diameter Number ____ _____. Rock Filled Yes E] No 0[ ] ------------------ Water Table Depth ------------------------------------------------Rock Size Distance to nearest: Well ----------------------------------------Foundation -------------------- Prop. Line ...................... REPAIR/ADDITION(Prev. Sanitation Permit# -------------------------------------------- Date ___--______________.___-_______-) Septic Tank (Specify Requirements) Disposal Field (Specify Requirements) -------------- ----------------------------------------------------------------------=------------------------ ------------------ --------------------------- - - - - - --------------------------------------------- - - ------------------------------------------------------------------- raw existing and required addition on reverse side) 1 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. Home owner or licen- sed agents signature certifies the following: "I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in such manner as to become subject t ;Workman's Compensation laws of California." Signed --------- ----------------------- -------------------------------------- Owner BY (If--- -- - -- -- ----otheran owner)+I ---------- -------------------------------------------------- Title ------------------------ th -------- -- --- -------------------------- FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY ----- --- - --------------- BUILDING PERMIT ISSUED _= - - - --------------------------------------------------. DATE _- - -.I_Iv. f 7 -----------' ADDI IAL.COMM TS -- DATE - _, - � ?r - 4� 1 ' -- ------------------------------------ Final a ___ ..__-_ _ _. - - Final Inspectionby. ` � --- - ----- - ----- - ._ ---------De -- _- 1 - SAN JOAQUIN LOCAL HEALTH DISTRICT E. H. 9 1-'68 Rev. 5M