14485 - Laserfiche WebLink

Home Browse Search

----- - K�rr7 1 .- -.. "• ... - � �- --__- .__-. � APPLICATION FOR SANITATION PERMIT Permit No. ...B/ ....... . (Complete in Duplicatel 7` Date Issued __. -----. This Permit Expires i Year From Date Issued .__/ ._G_T✓ 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 withCountyOrdin ce No. 549. 1 JOB ADDRESS AND LOC ION-- . _! D h� 1 --c [.G. ll ---------- Owner's Name........ -Q.,- PhPrue � ��%�� Address �5-�� .AA� -----------------------------•-----•-. Contractor's Name---- - s c¢..- `=-1.`1_-IL !Z-1 '. ........................ Phon Installation will serve: Residence partment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other Q Number of living units: I...... Number of bedrooms _X_ Number of baths .�__ Lot size __ ©. __�................... Water Supply: Public system Community system ❑ Private ❑ Depth to Water Tableft. Character of soil to a depth of 3 fe6f: Sand ❑ Gravel ❑ Sandy Loam ❑ ClayrLoam ❑ Clay ❑ Adobe , Hardpan ❑ Previous Application Made: (If yes,date---.----------------) No ❑ New Construction: Yes 0 No FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: No septic tank or cesspool permitted if public sewer is available within 200 feet.) 'Se'tic Ta k: Distance from nearest well_________________Distance from foundation............--------Material-'t__.--.--_-___.___--__._.......:..........._.... No. of compartments----- Size--------------------------------Liquid depth--------------------------Capacity....................... ' osal )Cl: Distance from neeres well f------Distance from foundation____/__,Q ......Distance to nearest lot line---- �.. "7 Number of lines_______ __ _______.____.__ ._Length of each line.... -----------Width of trench___.c f�_.______________ Type of filter material.�_�{{____Depth of filter-material------18P`_._Total length........4919.e---------------------_ Seepage Pit: Distance to nearest well_______________'------Distance from foundation_...................Distance lo nearest lot line----------------- ❑ m Number of pits---: ..---_--Lining material-----------------------Size:,Diameter--------------------------Depth----.---------------------------- E Cesspool: Distance from nearest well-----------------Distance from foundation.....:_--------------Lining mAterial-...-_..____.__________---•---------. ❑ Size: Diameter-------------------- -- -•---._--•-Depth--------------------•--•---•---- ------------------Liquid Capacity.----•-------------•--......gals:. Privy: Distance from nearest well____________________________________------------Distance-from nea est building----------------------------------- ❑ Distance to.nearest lot line------- -- ----------------------------• ----------------------••----------- ----------------------------------------------------- Remodeling ----------....._..--•------------------.-----------Remodeling and/or repairing (describe)-------------- ------------------------------------------- r ------------------------ •-------•------- ------ - ----- -•- ---------- ------ --- --- -- ---- _... - ----•-----_-----------•--------------------------------------- I hereby certify that-I ared this ap is tion and +hat the w k will be done in accordance with San Joaquin County € ordinances,�4tat�law�, nd ules and reguiations of the San Joaquin Local Health District. (Signed)---- - ----- - - ---- - ---SL/...r --- - ---•- - ----- Contractor) ----- ----- T"i+le j BY: . - { )----------- ----------------------------- --•---•------- (Plot plan, showing size of lot, location of system in relation to , buildings, 91K-, can be placed on reverse side). R DEPARTMENT USE ONLY APPLICATION ACCEPTED BY--- -• .—_�------------------ DATE------- --- ------------------- ----------------------•- DATE BY-----------------------------_;;10--------- ---------------------------------------•---------------- ------•---••----=-----------...---- BUILDING PERMIT ISSUED............................. r DATE.: ` Alterations rid/or recommendations:. .�� -r~� !_ -------------------------------•-•---..........------------ .................................-................. ----- --- ---- ----------------- ....- .... FINAL INSPECTION BY:. ..-- --------- Date....... - Z-- ►" I SAN JOAQUIN LOCAL HEALTH DIS ICT 130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stocklonr California Lodir California Manteca,California Tracy,California CS 9 REVISED 8-S9 2M 3-61 ATLAS