3469 - Laserfiche WebLink

Home Browse Search

APPLICATIONS FOR` t 1�. SANITATION PERMIT =Permit No,13_Y_b___________ U 3 ►-"'` � (Complete in Duplicate) n ,Ia Date issued ��_!�,--_-- Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. u This application is made in compliance with County Ordinance No. 549. 923 Bryan Street; Stockton JOB ADDRESS AND LOCATION--------__ _ __...__.-_-._ Owner's Name------------------------- Mr. Charles Scott ,�3$1� ----------------------------------------------------------- Phone 11", Address------------------------------------ Contractor's -------._--•----------- ------- 936 La Follette cit StbCktOn Contractor's Name--------------•------------------1'lISIH INC,* --------- ------ Phone----9`-g6v7-------- Installation will serve: Residence: ] Apartment House ❑ Commercial E] Trailer.Court ❑ Motel ❑ Other ❑ Number of living units: __------- Number of bedrooms -- __ Number of baths 2..... Lot size �o- x 100 t -------------------------------- Water Supply: Publics stem Community system ❑ Private ❑; Depth to Water Table � ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam•❑ Clay Loam ❑ Clay ❑ Adobe 91 Hardpan ❑ Previous Application Made: Yes ❑ No ❑ New Construction: Yes ❑ No ❑ ! I 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-----------------Distance from foundation-----------..-------Material __.______:_______. _- Ex ting Na. of compartments------------- ----------Size--------------------------------Liquid depth---- ------;-=---`---_ - Capacity----------------------- . Disposal Field: Distance from nearest well------------------Distance from foundation--------------------Distance to nearest lot line-.-_____-----._-- : Ex�pting Number of lines------------- of each line------------------------------Width of trench------------------------------ - Type of filter material----------------------------------Depth of filter material----------------------- otal length------------------------------------------ Seepage Pit: Distance-to nearest well None Distance f or�.,fo ndation-_15"___ 1-Q � 1 C� tir' C --- nce to nearest 1 t iye_________________ Number of pits Lining materia; Sze: Diameter ----..Depth_----� ---------------------- Cesspool: Distance from nearest we11------- ------Distance from foundation___-----------------Lining material------------------------------------------ r El Size: Diameter--------------------------------------Depth------------------------------ ---------------------Liqu;d Capacity----------------------------gals. Privy: Distance from nearest well__.--______________________ _______________Distance from nearest building---------------------------------- Distance to nearest lot line------------------------•-------•---------------•------------__---- ------------------------------------------------------------------------- Remodeling and/or repairing (describe)-----------------------------------------------------•---------- •-------------------------------------------------------------------------------- ----- ----- ----- - ----- -- --- --- -- ------------ ---- ----- ------ - --- ----- 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. i PARRISH IPTG a e a (Signed) ------------------------------------------------------------( �yContractor{ By:----------------------------------------------- jjrel�afion � �,J { } Estimator u�--- ----- Title (Plot plan, showing size of lot, location of sysfe to wells uil�lings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BYS ------------------------- ----------------------------------------------------- DATFI� REVIEWED BY ----------- DATE -�-------- BUILDINGPERMIT ISSUED--------------------------------------------------------------------------------------------- -------- DATE....---- A terations and/or recommendations:. ------------------- -------------••----------------------------------- ----------------------------- --------•----------------------------------------------------------------------------•------------------------------------••---....------•-----...... -------------------------------------------------•---------- --------------•-------•------------------•--•---------------------------------------- ------------ --------------------------------------------------------•---•-------•-•--------------------------------------- ---------------------------- i FINAL INSPECTION BY:------ ------------------------ / c - Date - -i------ SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street . 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2M 10-52 Revised W-2100