7224 - Laserfiche WebLink

Home Browse Search

. " APPLICATION FOR SANITATION � . ' �m� N� � ' i� -7'---'-�'- (Complete in ' ��' �� - Date Issued �1 ContractorsApplica-l'ion is hereby made to the San Joaquin Local Health District for a permit to construct and installthework herein described.- This application is made in compliance with Counfy'Orj)'nanc,� 549. LOCATION_)61f.&_ ---------------- ----- Name ''''_----. � Installation will Residence ffr Apartment House U Commercial U Trailer Court U M [] N-'-- - ''lii-x -'- ��munity -- '` � � ~ ~~-'`--' ~^'~`' of ~ - - ^' �^~ '"- ^~' ~~~ '� ��'~^ ~-~~~d--------' Water Supply: Public system system [] Private E] Depth to Water Tubl*M_43` ( Character of soil to a depth of 3 feet: Sand n Loam El Cloy [] Adobe [] Hardpan Prev�u� ApplicationMade: Yes-E] No Construction: Yo, -_- ~� TYPE OF INSTALLATION AND SPECIFICATIONS: /No septic tank or cesspool within 200 � 0Soofc Tank: Distance from U No. � �mpo��--��_- -- '�� ,� _'- _'- --,-_'--`��-'�� � Disposal Field: Distance from nearest well----- from foundation F� Number of lines' _15 Length � e �� of french � � ----------------- Type .-' ,_ Tvoo of filter mu+ . uf of filter m�fu6�|-~ length _�___ Soopoge Rt: Distance to nearest ~eU -------------------Distance. fr,m foundation--------------------Distance tu nearest lot line------ ''-' [] Number of p�-fs----=---Ljning mufuriui---- ----� Diameter_-----.Depth...........-----.- ' Cesspou : Distance from nuunut well-----------------Distance from found ofion----------------Lining material -- ------------.___ [] Size: Diameter--------------------------------------Depth-------------------------------------- -------------- Capacity----------------------------gals. Privy: Distance from nearest well----------- --'----Dish,ncm from nearest building------------------------ -------____ E] Distance to nearest lot |im, ------------------------------------------------------------------------------------------------------______________ Rnmq6rinV "n6/or repairing (6apzibe):--------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------- --'''''---''--'''--'---''--'''--------------'--'----'-----'--'--'-'' --------'--''-''---'-'''-'---'---''---''---''--''--''--'-'''---''---''-'''--'-----'------'-'-'- ---'-^---'---'-------------------'----------------'----------------'------- \ I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County "`"`° , ----------------------------------------------------- �------------------- ---------------------—- �''- ��.t-'---''--'' --------------------------------------- J / (Plot plan, showing size of lot, location of system in relation fo ~6lls, buildings, efc° can be placed on reverse sici '' F9X DE �"ENWE ON ' APPLICATION ACCEPTED RY.-v~�5� ^�~ , ~'--,r��- RENEN/B} BY-''''--''-''''-''-''-----''_-''---'--'-''''-''''--. DATE-----'------'---.--_..--_- BU|LD|NG PERMIT ISSUED-------------------------- -_-''-'''_''--.''''''-''''--'_. DATE---------___''-''----''-_______ � Alte,atiwns and/or ,wcnnmon6at|wn,;--------------------- ----------------------------------------------------------------------------------------------------------------------------------------- ------------------------------- __'____________________�______________'__________ _ ____________'_________________ ----''-'-----''--''--'-----'-'-''''--'-----'''''--''''-'''--''-------'-'----''-'-----' '-'--'-''-'-'-''''�--''—''--'''-'''---''--'-'--'�''- --'�--'''-''--'-'--''-'-'-'-'-- ' --'-_''-----.---'--'''-'~'' r -'''--,''''-- --------------------------- Date -''''--'' _ Do+e - ��N \L INSPECTION DY;-''--'' ' � �'�/L�� '-'._----'''''-'--.'--_-'''--- ~ --�'------ SAN -' SANJOAQU|N ' LOCAL HEALTH DISTRICT - � __/� South American Street s� \� � Street 132 Sycamore Street ow North "C" Street Lodi, oaVfo,nia Manteca, California Tw*, California 145446AT°"=, 12-54