76-122 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: APPUCAMN FOR SANITATMN POW ........... .�_�. .� .............................. Omph"M TripHcab) Permit No. ....... ..........6 �2 Date,Issued ..__................ .................................................. This Permit Expires 1 Year frac Date Issaed 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 and existing Rules and Regulation:: 365 Adrienne JOBADDRESS/LOCATION ...................--...................--•-•-...........................-..............................,.CENSUS TRACT .......................... Owner's Name G-al.].et-tL--Re-al.ty............................. .. .. .. .....Phone ... ....: Address . E. Miner City Stockton Contractor's Name Roto Doter Viewer ser. License# 271539 Phone 4b5-2616"...... Installation will serve: Residence 0 Apartment House fl Commercial[}Trailer Court C3 1 Motel 0 Other............................................ es 0 b 100 er Number of living units:............ Numbof bedrooms ....•.._._.Garbage Grinder ........... Lot Size ............................................ Water Supply: Public System and name -C.aLif.,- Xat.er-S•er............._....................................................P i 0 r vote Character of soil to a depth of 3 feet: Sand 0 Silt Q Clay 0 Peat 0 Sandy Loam.fl Clay Loam Q Hardpan❑ Adobe 0 Fill Material ..RR....if yes,type............... ............ (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side,3 NEW INSTALLATION: No septic tank or seepage pit permitted If public sewer is available within 200 feet,) PACKAGE TREATMENT ( 7 SEPTIC TANK{ ] sin................................................ Liquid Depth .......................... Capacity .................... Type .................... Material...................... No. Compartments ......................6 Distance to nearest: Well ......... .......................Foundation ...................... Prop. Line ...................... LEACHING LINE [ J No. of tines ......................... Length of each line................ .I............ Total Length ............................ 'D' Dox ......-..... Type Filter Material ....................Depth Filter Material .........................................•..� Distance to nearest; Well ........................ Foundation ........................ Property Line ........................ , SEEPAGE PIT O Depth .................... Diameter ..............'.. Number ............................ Rock Filled Yes ❑ No (3 Water Table Depth ......--•--•......................_..•-•........Rock Size ................................ Distance to nearest: Well ........................................Foundation .................... Prop. Line ...................... REPAIR/ADDITION(Prey.,Sanitation Permit# ............................................. Date .................................. Septic Tank (Specify Requirements) _..............rep-1•a-ae•• ..wit•h.:n-e-i...........-•.............. Disposal Field (Specify Requirements) 1Q...g aL7oxa...�sxc;�: �...p e--_�.pts.t...t ?k ........................................ .............................................................................................._................................................... --------........---..................... (Draw existing and required addition on reverse side) I hereby certify that i have prepared this application and that the work will be done In accordance with Son Joaquin County Ordinances, State Laws, and Rules and Regulations of the San .Joaquin Local HeaW DisMc#. Henle owner or licew sed agents signature certifles the following: "I certify that in the performance of the work for which this permit is Issued, 1 shalt not employ any person in such manner as to become subject to Workman's Compensation laws of California." Signed .. .... Owner By �,� �; X WYJE Contractor y ... �..... Side ........... ... . (I er tha aerj�wn DEPARTMENT USE ONLY BUILDING PE ACCEPTED BY ...... ,- •--•--------------------•--......._.... .:...........-.--_-.-......_.:,.. DATE .. -. /. -...... - APPLICATION PERMITISSUED ....... ... ...:... ... . ..._..._._.:............ .._......... -••--•---...-...I._...............•..DATE .................................... ADDITIONAL COMMENTS --.... •.. ..... ............................. :.............:............ ................_ :......................... .._ ...., 3 ..........................._..........---.............-• --•---,.... .......---:.-.... -....................__...--•- .....----•-•••.. ........... .. ........................................... ...................... Final Inspection by: ... .EH / -.......................................... ....._. .._................ _Date �/ •=,,/... .._ Q,.....------- 13 �` 1-684 JOAQUIN LOCAL. HEALTH DISTRICT 8/7,4 3M