10739 - Laserfiche WebLink

Home Browse Search

Permit No. APPLICATION FOR SANITATION PERMIT 3 4 113AI (Complete in Duplicate) Date issued District for a permit to construct and install the work herein described. Application is hereby made to The San Joaquin Local Health Ordinance 1,10. 549- licatiori is made in compliance with Eunty Ordinance No 0-1-1 This app - - -- - -- ------------ - ---- -------- JOB ---------------- ------------------------••-------------------• -------------------------------------I-------- --------21!70ik- ------------ ------- JOB ADDRESS AND LOCATION ------- Phone------------------------------------- --- ---------------------------- ---------- U Owner's Name_____________ rn— ------- --------- A. ---mz- ----------- ------------------------------------------------------------------------------- ---- Address------------- --------------- Phon _�Zqjl MOT-----2 - ------------------------------------------------- Contractor's Name- Commercial [] Trailer Court El 'Motel ❑0 Other �4aklox Installation will serve: Residence El Apartment House 0 -------�,e ------ Number of living units: mbar of bedrooms 4---Number Deb}�h�o-�ater Lot sizePubk'system mmunity system El Private 0 pTable ff.4 Hardpan 0 Water Supply: VC0 ravel El Sandy Loam D Clay FHA/VA: 0 clay E] Adobe W<a,Character of soil to a depth of 3 fee+: Sand Yes [3 No No �Ne, Construction: Yes 0 No Previous Application Made: Yes F1 TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or'cesspool permitted if public sewer is available within 200 feet.) Material----- --- ---�e----- ------------- nearest we1I_jA&_rJL,,_Di,fanc from founclafion-J- ----------- .1 - c T -. ' 1.k depth_: __1----------�_, apacity- -------- Septi Distance from _�j ... dep, 7-7- - �Ca ;y No. of compartments--_--I---------- ---------Size __ ___ 1� 'I Irtotm foundation-So /,a------Distance to nearest lot line-Z �ance Disposal 'Id Distance from nearest wellJ-'VG'0---�- 0 trench___a-54��----------------- FA Length of each line,-q- _!-----------------Width of t Number of lines----- -a----Depth of filter materw1_1.9f----------Total length-__-.-- -•0--------------------------e Type of filter material- from founclation--t-W--__Distance to nearest lot line__.__ T,"L... g it: Distance to nearest well-_ —------Distan efer---313/1------Depth......2-6-4,•----------- Seepa Number of pits---- L---------------Lininq material ----Size-. Diameter----.-1ining material------------------------------------- V ce from foundation----------------- Cesspool: Distance from nearest I .well-----------------Distan ------Liquid Capacity----------------------------gals. Size: Diameter-------------------------I------------4-Depth---------------------------------------------- ElI Distance from nearest building----------- ----------------------- Privy: Distance.from nearest well------------------------------- ----------------------------I--- ------------------------------------------- Distance-to nearest -------:-------------------------- El --- - -------- - ----- Re 6eling and/or re airing {describe? -------------- - ----------------- -----------------------I-------------------------------------------------------- - 0--_ --------------------------------I--------------- Q-15-- - -- - -------------------- ------------- ------------------------------------------- ---------------------------------------- ---------------- -hat -•------------------------ ________ I--------------------------------- ------------------------------------------------------------------------------------------------------ that the Work will be done in accordance with San Joaquin County I ho,eqbXcerfify that I have prepared this-application'and ruts and iegu f JQ quin 6 a?" ealth District. ordina.c_N c 0 laws, and Contractor} --- ------ ......... ........_.........X a LL (Signe ----- ---__ -T---)t- -_ -- (Titl ------------------------------------------------ --------------- By:-------------- I------------------------------------------- - cation of system in relation S, buildings, c., can be placed on reverse side). (plot plan, showing size of lot, 10 FOR DE RTMENT USE ONLY DATE ----------------------------- -------------- -------------- - ---------------- ------- --------------- APPLICATION ACCEPTED BY-- ----•--------- - ----------------------- DATE------ BY------------------------------------------------- ..... ........ ___ DATE-- ------S___-------------------;------------------------- BUILDING --- ---------- BUILDINGPERMIT ISSUED------------------------------ - ----------- ------------------- ----------------- ----------•--------•---------------------------------1------- - ---I---------------------------------------------*1------- Alterations and/or recommendations:__-__-------------------------------------------------------------------------------------- -----------------------------I------------------------------------- --------------------------- ----------I--------------------I------------------------------------------------------------- ----------------------------- ---------I--------------------- -------------I-- ------------------------------------------------ ---------------------------------------------------------------------- ----------- -------------------------------- - -------------------------------- ------------------ ------------------------------------------------ -------------------------------------------------------------------------------------------------_------------------ _ - - -_ . -------- I ------------------------------------------------------------- -------------------------------I-------------------------------------------- --------------------------------------- Date -------------------------------------- JOAQUIN LOCAL HEALTH DISTRICT FINAL INSPECTION BY:_..-, ------------------ L SAN 132 Sycamore Sfreet 814 North -C" Street 130 South American Street 300 West Oak Street Manteca, California Tracy, California Stockton, California Lodi, California FS-9-2M - Ravise6 1-57 F.P.CO.