6770 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT _ Permit No. --------------7_ (Complete in Duplicate) . . Date Issued ------- -- -�� APpplica}ion�is hereby made to the San Joaquin Local Health District for a permit to construct and install the.work herein described. This'�a lic�Alion,is�made in compliance with County.Ordinance No. 549. V ._ JOB ADDRESS AND LOCATION J� �� '�= ----�'�--V ._V.0 � Owner's Nama-------------------J �c3 (f' �' Phone VVk� '="Address------------•---------"-"--•---•-••------•--- .l ;; .;! J Contratfor's Name------------------- --- ------- •- -------------- ------- Phone---------------------------- 7_-__ F Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel.❑- -Other ❑ -� Number of living units: - ____ mber of bedrooms -_____-Number of-baths _ ... Lot size ---7.5---___.hf /_J___�------------------- ' Water Supply: Public system Community system ❑ Private ❑ Depth to Water Table. 1f? Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam lay Loam ❑ Clay ❑ Adobe ❑ Hardpan ❑ Previous Application Made: Yes ❑ No [.]. New Construction: Yes No ❑ 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 ..___ Dista ce from found�jon_��.__..._---Material _'__._______- ,,. -_Li uid de th_____ Capacity 424-d.._.. No. of compartments----2.-_____._,_.-.._Siz7v _ - q ; '_ -- p ty_ Disposal Field: Distance from nearest well._5'._-{--.-Distance from foundation-._. Distance to nearest lot line--- ---- Number - Len th of each line 3l2+ �i ".Width of trench-.,,I ------------------- -Depth ---_________ �V � Number of lines----- ---- --------j 9 >- r� . �� - Type of filter material.- -Depth of filter materaL._f_ ._.- Total length_____ ,1 --.- 1: Seepage Pit: Distance to nearest well----------------------Distance from foundation--------------------Distance to nearest lot line---.-.______--_- ❑ Number of pits----------------------Lining material-----------------------Size: Diameter--------.-------- ._.__Depth-:------- ----- ----_--_-- Cesspool: Distance from nearest well--------_---------Distance from foundation.__-----------------Lining material__..___.."__--.-:--.-------..__------� �Y ❑ Size: Diameter-----_----------------------- Depth----------------------------------------- ------- --Liquid Capacity-_. aalst _t - _ - - _____._Distance from nearest building � . Priv � �Distan�ce�prom nearest well.----------Y.".------_---- - 9-------------------------•------------ [] Distance to nearest lot line-------- ------------- ------ ------------------------------------•---------------------------------------------------- --------------- Remodeling and/or repairing (describe):--------- ---------.-_-.---- ----------------------- --------------- ------------------------------------------------------------ -------------- ----------------- ------------------ ---------------------------------0 ---------------------------- -------------------------- -------------------------------------------------•--- ------------------------------------------------------------------------------------------------ ---- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, St to laws, and r les an Lrgulations of the San Joaquin Local Health District. r � (Signed) .------ . -- ------------------- -- ---- - ------------ --------------------- (Owner and/or Contractor) By:...... :------ ---------------------------------_�.-.----------------------=-------------------------------------------:--(Title)---------------------------- _------------------ If ---- --- (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENTUS NLY of _J0 APPLICATION ACCEPTED BY 4 F DATE "f REVIEWEDBY------------------------------------------------------------------------------------------------ ------•------------------- DATE--- --------------------------------••---------------------- BUILDINGPERMIT ISSUED-----------=----------------------------------------------------------------------------------•----- DATE----------------------------------------•-------------- Alterations and/or recommendations---------------------------- - ------------------------------------------------"--•-----------•-------- •--------------•-----------------------------------•-•- ' ------------------------------------------------------- --------------------------------------------------------------------------- -- - ------------------------------------------•---""-----------•-'--------------------"------------------------------------------------------------ -----"--------------------- ----------- -------- --------------------------- ----------------- ------------ ------------------------------ FINAL INSPECTION BY:----; �� ------------------=----------- Date SAN JOAQUIN LOCAL HEALTH DISTRICT ' - 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" S+ree+ 1 Stockton, Ecliforn:�` E.odi, California Manteca, California Tracy, California E5--�9-2M1F x,'145446 A7W