5559 - Laserfiche WebLink

Home Browse Search

��^ . . , APPLICATION rwm SANITATION PERMIT Permit No kC�mp�fo 7n Duplicate) ^ V ' ��' Date Issue- ----'' -_ '.`__�. plka-�ion is hereby de to the Son Joaquin Local Health D�+� for a permit +ncnno�uct and ��uUthe*o, heron described. 7�h application is made in FJiawifh.County Ordinance N 5411, ' -'_r'- N_ .---- -------- ------- -------------------------------------- . .__--�-___----.� Address- ' '\- ' Installation will Residence � - C | -- Trailer __ oto _- - ' . Number of6oJom� / N ` '_Num6orof |��g units: Water Supply: Public system Community system E] Private [ Depth to Water Tab / ' � Character of m@ to a depth of 3 feet: Sand [:] Gravel 0 Sandy Loam El Clay Loam E] Clay [] Ado Hardpan Ej ! Previous Application--_ Made: Yes Ej . New Construction:c.t�on' ve�' No � - � � TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic,ep+ic fanko, cesspool permitted if public sewer` isavailable within 200feot> - Septic ' nk Distance from nxmnst well-----------------Distance from foundation---------------------Material----------------------------------------------- | No. of compartments----------------------- ..Size--------------------------------Liquid 6ap�h-------------- ---------Capacity----------------------- / D�oom Distance from nearest well — ----------Distance from foundation-------------------- Distance to nearest lot line__-.'-- / Nvm6ur of lines-----------------------------------Length of each line------------------------------Width oftrench----------------------------------- ' Typ!e of filter maferial-------------------------Depth of filter mm+eria|-'-'---Tot | length-'--__---__----_- �- �� ' , , ��u e ,n: Distancern �v �/,,��s�' wmn n, from --Distance to nearest lot / --------------- Cesspool: Distance from nearest well-----------------Distance from foundation --------------- Lining material-----------��'=_' 5�e: Diomutec.--.----_-__Dept h_----.�_-.---.-_-..'.UquiJ Copac�y '_'__---��qo6. . . � Privy: Distance from nearest well'-'—''_'_'''_''__—Distance from nearest building.----------------------------------------- Distance �'''-_'--_-.'-'- Dis+m ce to nearest |o+ line` - --_-.-----_-------_---_..-_...`_.._--_-_-'—....----''--'_--..-_.__--_--_---.__._-»�~-._-_—.—.. . ----''---''''-----'-''''--'--'--''------''''------''--'----'---'---''-------''----------'—'' | 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, an ul and I Non of the San Joaquin Local Health District. (Signed)--. '- By:------- ^." le)(Plot plansho ingsi 0 ofnt, wcatm of system mrelation to wells, buildings, etc., can mo �2Xoneversemid pe-. FOR DEPARTMENT USE ONLY ' REVIEWED BY-------------------------------- .��.�-----_-----_.-_-___' D/��.-_-_��/' �7 �� ,�` �� "r' `----- -----''' BU|LD|NGPERk4|T |S5UED.-_-_-.---_-------__--.-_.___-_.--- DATE------._--_.—'_.-_--__ ^ AKo,utionswnJ/o, recommendations------------- ----------------------------------------- _ ------------ . ----------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- -''-_-'''-''_--'_---_'---.__.-_.- . -._-___---._'---_----------.------._-_----._-'-_--'_-_.-_----_._.--' '�```�`��``�```��``�```�`��```�```��```��`��``��``��`��```��`��``�`��`�```�`� � . ---_-----_---__----______---_---_---___---____ ___�__�_�__�___�__��__��____��_�_��_��__�� el HN/\L |N6PE�7|C)N BY�-.''''_'��.'�� Ou+e-''-'-''��'--��-�� Ao ----''-_ SAN JOAQU|N LOCAL HEALTH DISTRICT /xo s"um American s*wm xooWest Oak Street /sz Sycamore :a=w+ u/* North ^C^ Street St="kt=, California L"a|. California M°"+°=. Ca|atimi" Tracy, California / e3-9-«w n°v,m6 W-x|no ,