Laserfiche WebLink
APPLICATION FOR SANITATION PERMIT <br /> (Complete in Duplicate) Date Issued/Inz <br /> Application 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 /> Installation will serve: Residence K Apartment House E] Commercial E] Trailer Court Cj Motel El Other El <br /> Water Supply: Public system X, Community system F1 Private Ej Depth to Wafer Table,�_Jft. fx/,. <br /> Character of sail to a depth of 3 feet: Sand E] Gravel 0 Sandy Loam El Clay Loam El Clay 11 Adobe K Hardpan E] <br /> Previous Application Made: Yes E] No K, New Constrmcfion: Yes F] No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well__rT7_-t�-----Disfance,,from oundation- __;o--- Material---- ----------------- <br /> No. of compartmenfs___-7-_—V_V,6--------Size—, i jr ' <br /> Disposal Field: Distance from nearest well__.T"r=w��._Distance frorrf foundation--- ---------Distance to nearest lotline--- <br /> ------------Length of each line......1�4 -_it------Width of tren - --------------------------------)�4 <br /> Number of lines- <br /> Type of filter materi_a1/;&-_' _011C.-Depth of filter material----- Total lengt <br /> Seepage Pit: Distance to nearest well- -------Distance from founda+ion--..oe.0�9-".---.D*stance to nearest lot line__-,.�� -------- <br /> Number of pits--40- ---Lining material---j61rj_lU<.,Size: Diameter....15----- Depfh1A <br /> -----------------------------------------------------------------------4e-------------------------------------- ------- --------------------------- ------------------- ---- ----------------- <br /> I hereby certify that I have prepare this application and tha+.the work will be done in accordance with San Joaquin County <br /> S�fa laws, and rules and e lations of fhe San Joaquin Lo al Health District. <br /> (Signed_ --- ------%r----- OR R --------eft: Jszd-,A�- -----��— ,___(Owner apd/or (;ontractor) <br /> -------------- <br /> --- -------- --re-ialin to wells, buildings, efc., can be piaceV on reverse side). <br /> I have prepare <br /> ',Iand aruland <br /> (Plot plan. showing siz of lot, location of system in <br /> FOR DEPARTMENT USE ONLY <br /> ------------------------------------------- <br /> ----------- - ''—'''''_--._-----------.,___—___------_--_'-_—__—____---..__--_. . <br /> � --_—''—'—_''----'--_''—'''-'—'—�''---'.---'''---,-'---_''''—_-'--_�-'''—''''—_.'--''___--_—''__ . <br /> ----------------------------------------- ------------------------------ -------------- --------------------------------^--------------------------- ----------------------------------------------------------------------- <br /> ����_��___�__��__�_���'__���___�_��_��_��__��_� <br /> ________________ <br /> ,��' _S_ l <br /> RN/\L INSPECTION 8Y�— \�---_. -------------- Date------ _ <br /> SAN JOAQU|NLOCAL HEALTH DISTRICT <br /> � on svmh *m",|*w" svmm 300 West Oak Street /»z Sycamore Street o|+ North ^o^ $+w°t <br /> Stockton, California Lodi, California Manteca, California Tracy, California � <br /> ' <br /> ES-9-2M B-51 Revised W-2100 <br />