73-224 - Laserfiche WebLink

Home Browse Search

r FOR OFFICE usE: , APPI.ICATIaN"FOR SANITATIONPERMIT v 3 Permit No. -'_7 - ---------------------- ---------------------��i ------ : . -- � Complete in Triplicate] Date Issued __..- ---=-.t�-7:.73 + This Permit Expires 1 Year From Date Issued Application is hereby made to the San Joaquin Local Healtf�District,for tato onstr"uct install the work herein described. This application is made'in compliance--with•Counfiy`',,Ord- Ince No X549 a�d`'existing ales and Regulations: JOB ADDRESS/LOC ON ---------- + --1_. --CIaN U5 TRACY ---------------------------- :!57-11`7 Owner's Name r� }l Phone f City ------------------ --- ---------- Address -- ----------------------- j l Contractor's Name __ D-- --- __.License #� --- Phone _ �-�-1 `�=�E'-f •--- Installation will serve: Residence ❑ Apartment House❑ Commercial Willer Court l❑ _..Motel ❑Other -------------------------------------------- Number of living units_____________ Number of bed, ms ________ - _Garbage Grinder ....-------- Lot Size ----------------------------------------- -- Water Supply: Public System and name --------- _ ------ is---- Private [7] ; Character of soil to a depth of 3 feet: Sand'❑ Silt Gay -- Peat F-1 Sandy Loam -[IClay Loam El Hardpan E], Adobe Fill Material _____ If yes,type ____-___- T I ------------------- (Plofijplan, showing size ofplot, location of system in relation to wells, buildings, etc. must be placed on reverse side.[ O NEW INSTALLATION: [Na septic tank or seepage pit permitted if public sewer is available within 200 feet,) � FI PACKAGE TREATMENT [ ] SEPTIC TANK'[ Size -------- Liquid Depth _ ----------;`- Q rr ! � No. Compartments --- ----------- --- Capacity` tom---�- fYPef4x,-1.��''� Material- --- -- -- f� � p =.�� __ Pro Lines tante",fio nearest: Well ----/ ----------------Foundation ------ ----------- p• / : t j LEACHING LINE [ No, of Lines ----------�____f__------ Length of each line____-�-�---- ----------- Total Length____ -------•--" _ .i. 'D' Box _/V_0--- Type Filter Material Vo r i�C------Depth Filter Material ---:� -----------•----------- �G J Distance to.nearest: Well __- _;._�__--. -_____ Foundation -__�_.O ______---_ -- Property Line. __tel_-- --- =•-- 1 lr p Diameter _ __--- .Number�i--)------- S------ Rock Filled Yes o SEEPAGE PIT Depth _ _ . Water Table Depth ---------61- ------------------- --------Rock Size 12` ---- --------- k Foundation ---------- Prop. Line --------- Distance --------- = Distance to nearest: Well.____---/J_ "----------- REPAIR./ADDITION(Prev. Sanitation Permit# _.-_----.--------------- ------ Date -------------------- Septic Tank (Specify Requirements) _________________----------------------------- ------------------------------- i Disposal Field (Specify Requirements) ---------4--------------------------------------------------------------------------------------------------------------------------- - .x _ --------------------- -._,�. . $ t7 -----,�. --------------------------------------------------- ----------------- — ------------------------------------------------------------- ------------------------ (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 San Joaquin County`Ordi once , State Laws, and Rules ai id Regulations:of the San Joaquin Local Health District. Home owner or licen- PI sed agents-siinaturecertifies the following: "I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in such manner ? as to become_.subiect to Workman's Compensation laws of California." `_ ------- Owner Signed --- --�- - - - - ----- ------ -•--------• -----------4--__ -� <- By (If other than o ne — - _77. Title l r' ` + l t i f FO DEPARTMENT USE€ONLY rf _ APPLICATION 'ACCEPTED BY --- ------� -----_- DATE __.._ .. 7 BUILDING PERMIT, ISSUED ----------'-------- ------ -------- =---------- -------------------------- .-:--=-=--------------DATE -- ---- --------------------------------- 4-------------------------- •' -----=--------------------------- ADDITIONA-L--,--C--O------M-)--M---E--N---T-§--._: } ' "= --- --------------- --- ----------------- I 4° - ------ F_ - . -- - -----=------- Date _ - Final Ins ection b k l SAN JOAQUIN` LOCAL HEALTH DISTRICT M 1. 0/7/73 ::a `X V j-,, : _�f . Qn ,�� WV H. 9 1-'68 Rev. 5M i�