11727 - Laserfiche WebLink

Home Browse Search

F/0 i `APPLICATION FOR SANITATION PERMIT ��17 Permit No. (Complete in Duplicate) � 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 --------------loot --- # ------------------- V`�i_lk_ix>man.--- N�ar1o_��---------------------------------------------- --------------- Woodb3: id e R alt __--- Phone------------------------------------ Owner's Name --••--•---------------__~. __ Y----------------------------=-------------- ----------•-----------_-- 1902 Pacific Ave.. Address------------------------------------------------------------------------------------------•---------------------------------------------------- .......................................................... Contractor's Name -------- Roto ---- Ro-o-`l;-ex----Sv-wex-----S-e-Tv4r; e ------------------------------------------------------------- Phone H-0-•-5-2616----- Installation will serve: Residence IN Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: _1____ Number of bedrooms _a__-_ Number of bathsl______ Lot size____75-.___X___l3.5_f_________________________, Water Supply: Public system ❑ Community system Ej Private ❑ Depth to Water Table 45__ ft - Character of soil to a depth of 3 feet: Sand ❑ Gravel F-1SandyLoam ❑ Clay Loam ❑ Clay ❑ Adobe) Hardpan ❑ Previous Application Made: Yes ❑ No [][ New',Construction: Yes [Z No ❑ 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 --- XX--------- Distance from foundation__1-0 i_______.Material_-C.0--- R m1 a k ---------- .------------- J7 91 No. of compartments --- 2 -------------------- Size._56--- X ... 4_D ------ _--- Liquid depth --------- 40 ----------- Capacity -------- $Qi;i____,._ .,.� Disposal Field: Distance from nearest well_ -__XX-_ ----- Distance from foundation 1-0-t Distance to nearest lot line -.-V Number of lines ------ 2___ _ -__ _'.__ _ __ Length of each line._ ___75_f:-_______ -Width of trench --- 24 n_____________ ------------------------- 00- Type CType of filter material ----- l:_"`s_[1&k Depth of filter materia, l ---- 1.8_: ---------- Total length ---- 15_Q_�___________________________ Seepage Pit: Distance to nearest well XX------------ Distance from foundation--- 2d. -_____..Distance to nearest lot line --- _T_____--_ Ki Number of pits ---- $_2-_ ------- Lining material.__x-0PK-------- Size: Diameter_ ----- Depth_Ma-x_s____Q_f_:_2t_ 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 ----------------------------------------------------------------------- --_---------------------- ,------•-------------------------- Remodelin9 and/or repairing (describe)----------------------Ne_w_---,5_e ti•c-- $a tram----------------------•---------------------------------------------------•------- -----------------------------------------------------------•-------'---------------------------------------------------------------------------------------------------------------------------------- ------------------ --------------------------•------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- t 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) ------------------- Rato--- Ro-oter---- Se_w_ex----Sexviae ------ ---- . ( Owner and/or Contractor) --- - --- ----------------------- ------------- -- ------ - By:---------------------------------------------------------------- - --------------------------(Title)------------- Own -ex------------------- -- ------ (Plot plan, showing size of lot, location.of syste relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY--------- -- ---- -----�------------ DATE. l -'l-- d REVIEWEDBY ------------------------------------------------------------------------------------------------------------------------------- DATE-------------------------------------------------------- BUILDINGPERMIT ISSUED ---------------------------------------------------------------------- ------------------------------- DATE ------------------------------------------------------- Alterations and/or recommendations---------------------------------------------------------------------------------------------------------------------------- ----------------------------------- ---------------------------------------------------------=------------------ ------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•- ------ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - FINAL INSPECTION BY:..-._=�_{'_.__"------------ ----------- ---------- Date --- ------ ------------------_-- 130 South American Street Stockton, California ES -9-2M Revised 8-'59 F.P.Co. SAN JOAQUIN LOCAL HEALTH DISTRICT 300 West Oak Street Lodi, California 132 Sycamore Street 814 North "C" Street Manteca, California Tracy, California