13664 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: --------------- ----- ---------------- -;--------- ' -- APPLICATION FOR SANITATION PERMIT Permit No. ------- t,. .' ----`-- =Cl. (Complete in Duplicate) • �/ -- --- � This Permit Expires 1 Year From Date Issued Date Issued ------- '' 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. JOB ADDRESS AND LOCATION---_8.30._S_o. aro Ave, - ---------------------------------------- ............................................................ Owner's Name-----------------•---• -- �JQhn_.A:.--Mille?' Phone -•-- --------------------------- .!! Address - aame---------------•-•----•-•---•---•---•••-•-_.-----•••••--------••-----••----••--•------• . Contractor's Name--T-he----DAY--&__NrGHT--Septic Tank Service Phone---HD Installation will serve: ResidenceKo Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ I Number of living units: .]._.-.41 Number of bedrooms -2---- Number of baths __ ,--_ Lot sizB __,-_'], t__-X_--12t........................... Water Supply: Public system KK Community system ❑ Private ❑ Depth to Water Table _6-0, ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobes Hardpan ❑ Previous Application Made: (if yes,date__-=__--___.-------) No XX New Construction: Yes ❑ -Noll FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) , Sflptic Tank: Distance from nearest welIU01le-_--_-Distance from -xM 1-36_._X6 --•Liquid depth............--.._-._- Capacity 40 S -S -- P ty-•-••--• Disposal Field: Distance from nearest"wellNonp....._Distance from foundation-------10t-----Distance to nearest lot line.....5!-._.._. ] Number of lines_---_---------------------------Length of each line--------9Q1---------- Width-of trench---2Vf ---.--._-----.--_. - Type of filter,materiaExePt.__.Ek__Depth of filter material----is"-----------Total length......:--9Qg----------------------- Seepage Pit: D'ilfance to nearest well__X0M,6---------Distance from foundation---3QfDistnearest -Distance to nearest--l-o-t line...5... .........Number of pits-----1--------------Lining materiaL-.Rock-------Sizm _33-. ......--.:Depth �__-- � � Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material_.----------_------...._.---- -- ❑ Size: Diameter-------------------------------------Depth---•-----------------------------------------------Liquid Capacity------••--•-------••--------gals. Privy: Distance from nearest well -.--_------------------------------------------Distance from nearest building------------------------- ❑ Distance to nearest lot line i Remodeling and/or repairing (describe):--------------------------------- ----------Rep 1aainp,---defer.nct--.Sy-s em-,L--------------------•------------ - -• l ----- -------------•-•----2------------------••---,.. ------------•-------------------•---•--••----------------------• ---------•.........................-----------------------•------------------------ - � t ------------------------------------------------------------------------------------------------------------•------------------------------=-----------------------•--.....................---------------------•------------ 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, (Signed).The DAY--& DIGHT Septic Tank rvice ••---------------•---------------------------(� Contract IBy:------------------------------------ ------------ ----------------- -- -- ---------------(Title).. - (Piot plan, showing size of lot, location of system in r Pion to wells, bu g , etc., can be placed an reverse side]. FOR DEPARTMENT USE ONLY i APPLICATION ACCEPTED BY--- ----- ------ -------- --------------------------------------------- DATE-'.//------------------------ --------------------------- REVIEWED BY ---'--- - -------------------------•-------------••------------------------••-----------.- DATE..................... -.- BUILDINGPERMIT ISSUED---------------------------------------------------------------------------------------------------- DATE AFtera •ons and/or re mmendations:------- --------- - rr -••----- ----- --- ...- 4. 7.7n._6---�- r�•�-1 c 2(tl� ..,ll. - -------•_ ... s�----------------- i A --------------- 1.111-•----------------- ---------------- ------------------•------------••----------..------------••-•------------------•----•--------1111.. -- -------------------------------- ------------------------------------ -- - --------------------- FINAL INSPECTION BY:.... --... r ......_ Date------- f,� f (1 7-SCAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 Went Oak Street 124 Sycamore Shoot i 205 West 9fh Street Stockton,California Lodi,California Manteca,California Tracy,California ES 9 REVISED 5-89 2M 5-41 ATLAS