12516 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No. ..-l-Z ...�� (Complete in Duplicate) Date Issued This Permit Expires 1 Year From 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------280 --East--Poplar--St,-,---S-toc.kton-j-C.,il .fornia---------------------------------------------------------- Owner's Name--------Lf211].5---L011j_s__3_.__.Ferrj----------------------------•--------•-------------------------- --------------------------------- -----.-- Phone__H0!w64 -2-----•-------_-- Address-----2827--EPat._.PPp1ar-_� . , .Stock �n, .G�l' rnia----------------------------------------------------------------------- •-------------------------••- Contractor's Name-----M�PS aHomess,-Ina----+----------- ( --�`Q-)---- -------------------------- ---------------- Phone--L;0-6412------•--------- Installation will serve: as ante ZI Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units. _2____- Number of bedrooms 2-=eal\lumber of baths 1-e_a Lot size 75--X__264_______________________________________ Water Supply: Public system © Community system ❑ Private ❑ Depth to Water Table ________ ft. Character of soil to a depth of 3 feet. Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe:10 Hardpan ❑ Previous Application Made: Yes ❑ No [2 New Construction: Yes ® No ❑ FHA/VA: Yes ❑ No K] TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) - Septic Tank: Distance from nearest well-,h��____Distance from foundation--------0___.-----Material -_-_______________________________ . -- __ No, of compartmenfis_..._/� ______________Size___-_�!15�OX_;_:-------Liquid depth__f'-- -----------------Capacity- i Disposal Field: Distance from nearest well- Distance from foundat on.4©--�_____-- Dist ,Ao nearest lot line_-_-.-_-_____ l� Number of lines-- ---------------------------Length of each IineCu-5_! -Y._ a_.v d h of trench_..._.-----i�----___-.______--•-- Type of filter material_X0_C k---------Depth of filter material __l <---_---__..Total length___--_I_1_'p------------------------ Seepage Pit: Distance to nearest well-aha?(------Distance from foundation___/P,-'A"eAor_.Distance to nearest lot line_.,J�--------- D ❑_� Number of pits------ - Lining material_ _/B7_eA,___-Size: Diameter--_ _ - -------Depth-----ti _-___________-____ �J 1 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-- -- ---------------------------------------------------------------------------------------------------------------------------------------- Remodeling and/or repairing (describe):----------Aex-Muplex------------------------------------------------------------• -•-------------_------------------------------ ------ V r' --------------------------------J--------------- --------------------------------------------------------------- ----------------------------------------------------------------- ---- 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,jndlesand regulations of the San Joaquin Local Health District. Si ned - --- - ------- --------------------------------- ------------------~�------- -------------------------------------._.(Owner and/or Contractor) ----- ------------------ Tale BY: --------------- ----------- { ) (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEP RTMENT USE ONLY f i ACCEPTED BY ' fel --- DATE-- APPLICATIONr C REVIEWEDBY----------------------------------------- -- -------------------------------------------------------------------------------- DATE.-----------------•---------------------------------------- BUILDINGPERMIT ISSUED----------------------------------------------------------------------------------------------------- DATE------------------------------------------------------------- Alterationsand/or recommendations:.------------------------------ ------------------------------------------•--------------------------------------------•--------------------- ----------------- ---------------- - :� -^ J FINAL INSPECTION BY:-,,-- CDate � ---------------�� SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 Wes+ Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2M Revised 8-'59 F.P.Co.