Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
Permit No. ._ �� - <br /> APPLICATLON FOR SANITATION PERMIT �---- -- --- <br /> �] (Complete in Duplicate) Date Issued .- �7�--?A•- <br /> 4. <br /> 1 <br /> Applica{ion is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. --------------------- <br /> , <br /> JOB ADDRESS AND LO ATION.. -- - _ <br /> Phone------------------------- <br /> ---------- <br /> Owner's Name_--•----------_ --------�, _.. ��r`-� -.-�------ . .., . ... _. . _...�. <br /> • ------ ..---- -; :. -------••----------------- ------- <br /> -!��-------------------------------' <br /> Address ..--•---- ° _ _..._ .. <br /> -----. Phone_ <br /> Contractor's Name . ...... " � - ' <br /> Installation will serve:'. Residence f partment House❑ Commercial ❑ Trailer Court ❑ Mofie! ❑ Other ❑ <br /> 1-1 <br /> J; of siie _6..a. "IX..L_5� --------------- <br /> Number of living, <br /> system Number <br /> ommun of bedrooms❑ Pri ate0 ofbath <br /> Wate <br /> /__ <br /> Water Supply: Pu y Y Y ❑ p r Table ft.` s <br /> Character af,soilo a'depth of 3 feet: .Sand ❑ ravel ❑ Sandy Loam [❑ Clay L m ❑ Clay.El Adobe Hardpan ❑ <br /> Previous Application Made: Yes ❑ No New Construction: Yes ❑ No ❑ ,,' � 47� �. <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> F (No septic tank or cesspool permitted if public sewer is available within 200 feet.) < <br /> r� <br /> � <br /> - Septic Tan : Distance from nearest well_f�:-___Distance from foundation - --.Material--=--------- -- ----- <br /> „ -------�-- <br /> No. of compartments------- -------------Size-4-111119-34-1, <br /> ize___+___ 11119-34_1--..Liquid depth..-�._�----- --------Capacity�r -------- <br /> . . n - <br /> Disp^osa/l-Field: - Distance from nearest well Dis <br /> - _ fance m pp foundation_._ _1___}_:.__.Qistance to nearest lot Gne----- <br /> L9� g Width of trench._: _" _.._ <br /> Number of lines------- --Length each line --��------- <br /> Type or fi{ter material------ <br /> ----Depth of filter material --�_�------=--.-Total length------`c3��9'------------------------ <br /> •� , . ...__ ` r �.f 7;., like l <br /> Seepage Pit:. Distance to nearest well_f. '--Distance om unclation__l�0_.___.__.D�stance to nearest lot <br /> s___ -_-__Lining mater'sal _ - Size: Diameter___.- -±......Depth-----f,4_*'--------------- <br /> �� Number of pits--- _• - <br /> Cesspool: Distance from nearest well______________ __Distance from foundation----------.____:__..Lining material------------------------------------- <br /> cessp6ol: <br /> Size:'Diameter.----------- -------------- ---`--Depth_---------.------------- - Liquid Capacity gals. <br /> Privy, Distance fm ronearest well--- -- �------------------`- '_Distance from nearest building ----------`-A--- ------- ----------- <br /> Priv s.. <br /> ".—Distance to nearest lot I ne <br /> r � - <br /> 8 <br /> 4 <br /> F Remodeling and/or repairing (describe)------ --- --------------------------- ----------------.------ ---=---- --------- --...••-.-.•-----••--••--------------- <br /> ` -------------------------- - --------------------------------------,---------------- <br /> .tr ----------------------------------------------------------- <br /> -•• <br /> ------------------- -- <br /> -------------------------------------------------------- <br /> I hereby certify that I have_prepared this-application and that the work will be done in accoMance with San Joaquin,County <br /> ordinances, aws, and ru�arc���rns of the San Joaquin Local Health District. _ <br /> ' Septic Tank Service ontractor) <br /> (Signed)__ - ----1206-So--Ektorcido---HO-2�7£;_ 77 <br /> --- ------ ------------------- --- - -- <br /> . Stockton, Calif. ----- ------------- <br /> By:. ---.------------------------------------ ----- ------ -- ------ -- <br /> (Plot pian, showing size of lot, location of system in relation t wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY } <br /> APPLICATION ACCEPTED BY------------ ----- ---•-------•-- ---- , DATE <br /> REVIEWED BY------------------------------ :-?DATE 4`-------------- - <br /> BUILDING PERMIT ISSUED---------------------- --- DATE- = ---------- = <br /> ----•• _ = -- - - ------ <br /> Alterations and or recommendations:__-___..:-__.._ _ T <br /> ��, <br /> ------------------------------------------ --------- •- . <br /> ------------------- <br /> = 6 =G -------- <br /> r 3o i <br /> H <br /> FINAL INSPECTION BY:_-_-_--- "- ----------------------- <br /> -----------�--- Date.------y -----------------------------------------------••---------------•---- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street 132 Sycamore Street 814 Horth "C" Street <br /> Stockton, California ' <br /> Lodi, California Manteca. California Tracy, California <br /> ES-9-2M 145446 ATWOOO 12.54 <br />