Laserfiche WebLink
a v <br /> - r <br /> r FOR OFFICE USE: <br /> APPLICATION FOR SANITATION PERMIT <br /> _ __ _ a <br /> --- -- - - -- Permit No: _._��_�- <br /> - ------------ <br /> (Complete in Triplicate) - <br /> ------ --------------- This Permit Expires 1 Year From Date Issued Date Issued <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein <br /> described. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: <br /> t <br /> JOB ADDRESS/LOCATI N -IJ----Z�------VII-- -..-V I4--�I_�L7------ ---- ---- ------------------CENSUS TRACT + `s <br /> 7 <br /> Owner's Name ------- 40 J1 gJ ---------5mT4---------------------------------------- -•------ -----------Phone. 3✓�'�' <br /> Address �y t1� / L.F�1----------------------------------------- city _f -_--- <br /> Contractor's Name _._- _dVVfV am______-_ _._________.License # _________ <br /> Phone <br /> Installation will serve: f Residence E] Apartment House❑ Commercial ❑Trailer Court ;❑ <br /> I <br /> Mote! ❑Other ---------------------------------------- <br /> Number <br /> ---------------------------- ------ ---Number of living units:i._________ Number of bedrooms .________Garbage Grinder _______.__ Lot Size _._______________________________________ <br /> Water Supply: Public System and name ------------------••-------------------------------------------------------------------------------------------Private ❑ <br /> Character of soil to a depth of 3 feet: Sand'❑ Silt❑ Gay ❑ Peat E] Sandy-Loam ❑ Clay Loam "E], <br /> Hardpan ❑ Adobe ❑ Fill Material ------------ If yes,type ___________________________ <br /> W <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side.) <br /> NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) <br /> PACKAGE TREATMENT { ] SEPTIC TANK f ] { Size----------------------------------------- Liquids-Dep h ---------------------------- <br /> CaCapacity � <br /> p Y �------E.----------� YPe ___�--------- ---- Mafierial__________-_____-- o. Compartments <br /> ' �t� :_. ' -moi - r <br /> Distance to nearest: - ell ----=�_ ,---------------------- Foundation -_- _-'_i_.------- Prop.'Line --------_----------- <br /> 1. <br /> LEACHING LINE [ ] No, of Lines r" g _ `Total Length _________ ........ <br /> : �� <br /> ------- Len th of each line ..----•- <br /> 'D' Box ------------ type�F Iter Material --------------------Depth Filter M terial _ -----------------------------. ........_..� <br /> Distance to nearest: W I ________________________ Foundation ------------------- <br /> _____ Property—Line---- <br />