19244 - Laserfiche WebLink

Home Browse Search

L--F FFICE USE: - :�0------- ----- Permit No.APPLICATION FOR,SANITATION PERMIT" " Com lete in Duplicate) Date Issued(--- ------ p n Zov_`f 2- --"------------------ This Permit Ex ires 1 Year From Date Issued---------------------------------- nce No. for Application is hereby made to-the San Joaquin Local gena#h District for a permit fio tons+rucfi and -snstall the work herein describe - Thispapplication is made in compliance with County O __�r_-..-Al0 r " -- -- JOB ADDRESS AND LOCATION AS/---/ a�� '�'" phone________________" �� :.11- -------------- - ----- ----------------- Owner's Name----�-�r-. �-----� � -----------••------•--------------•- Address------•--------�-<--- -••----- `--1-4 O ,,� -- ----------------- ----------- Phone.---------•-------•-•---•-•------------- -Apartment Name-----------------1�'--X r'a- `,/ep0 -e?!- ---------- --------------------------------------------- ----- ----- Other Motel. ❑ ❑ Insfallation,will serve:. Residence Apartment House ❑ Commercial ❑ Trader Court ❑ �� •' al-__ Number of baths -- -- Lot size - Number of living ------ units; ___l"- Number of bedrooms th to Water Table �/P- ft. Public system ❑ Community system ❑ Private �ep Water Supply: Y Adobe❑ Hardpan ❑ Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Gay Loam Clay ❑FHA/VA: Yes ❑ No 9;-- Previous Made: (if yes,date--------------------1 No (� New Construction: Yes ❑ No l�� Previous App' r TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public'sewer is available within 200 feet.) Material---------------- I Septic Tank: Y Distance from nearest we}I___."--_---_____Distance from foundation________________ • Capacity------------------- f ---- ---------�-No. of compartments--------------- ---------Size------- -------- Liquid de%th --------- --- - t p /,�----_-_-_Dis#ante to nearest lot linea. ------.-.---- )un Disposal Field: Distance from nearest well...gl_09--- _Distance h ofrom each line ation._ _-- Width'of trench.r�---------------------------•-- Number of lines----------`.------. g ee Total length ---- E Depth of filter material-__--le ------ g _ �~ Type of filter materia4___ ,(�-lav-� F _49____-- is Q e to nearest lot link--, -y.-------- Distance fro fou dation__ 10VDepth- /- /� ' Seepage Pit: Distance to nearest well----�/�-" Size: Diameter -------- Number of pits-----/-------------Lining material--- -- ---- t Distance from nearest well___-----_.._'----Distance from foundation....................Lining material-_. ------------------------------ - i Cesspool: Liquid Capacity 9as. Size: Diameter---- ------------------------------- eph----------- ------- - . - ❑ m ---------------- Il` ce an I Privy: Distance from nearest well------_----------- ------- - ---- - �J ❑ Distance toynearest lot line------------------------------- ---- - ----- -- l . r !Cl Remodeling and/or repairing (describe):_--____-. --------------------------------------------------- ---------------------------------- ---------------------------------- ------:-----:----------------------- ------------- - - --- ----------------------------------•----------------------------------- Q r+fthat I hereby certify that I have'lPre aregulationsdthiIli the San Joaquin Local kHealth eDistrict. done n accordance with San Joaquin County ordinances, State laws, and rules l �or Contractor) 5t ned �_ , _�`.azl ---- -- -- - ( �9Title -- -- - - ---- -- --- -- - -- A ------------------------------------------------- in ---------------- -- (Plot plan, showing size of lot, location of system in r ion to wells, buildings, etc., can be pace on reverse side). FOUR DEPARTMENT USE ONLY q - [� C�"`� DATE------- +� '�- ---- APPLICATION ACCEPTED --------------- - ---------- ------ --- - ----------------------------- --- ----- - ----------------- ---------------- DAT - IREVIEWED BY--------------------------------- -------- -- - - - ------ ------- DATE --------- BUILDINGPERMIT ISSUED-J------------------------------------------------------------------------------ --- ------------------------------------------- � Alterations and/or recammen ations:_______________________ -------------------------------------- ------_____ E—N --------------------------------------------- --- ( - ---- -------- ------- -- -------------------------------- - FINAL INSPECTION BY:...-"._-._.- rAN Ti� Date---- --�------7- ------- -�-- --� . AQUIN LOCALHEALTH DISTRICT 124 Sycamore Street 205 West 9th Street 1601 E.Hazelton Ave. 3k StreetLodi,Cafornia Manteca,California Tracy,California Stockton,California