286 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT ' (Complete in Duplicate) P ) , Application is hereby made to the San Joaquin Loca! 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--------------------- X�VMX.XX -_____,____---1978 So. Sinclair Ave. - -- ------------------------------------------------•-------------------- Owners Name ------------ -----I TVI.- Treadway ---------------------------------------------------- ---------------------------- --------- Phone------------------------ Address --------•--------••-•--- 978 So. Zinclair - - -- -- -- --- -------- iA. Parr: sh Sons - ----- Contractor's Name ___ ___ 9-9607 _ Phone ----------------------------- Installation will serve: Residelnce - Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of livingunits 200 1 Y 300 1 { Water Supply: Public Number of bedrooms ] Number of baths [ Lot size________________________ ___ PP Y• I ❑ Community system ❑ Private A Character of soil to a depth of 3 feet: Sand ElGravel [I.. Sandy Loam E] Clay Loam ElClay [IAdobe ff Hardpan ❑ �VI TYPE OF INSTALLATION AND SPECIFICATIONS: -' I (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well---- 10 1 Con• glkS p Distance from foundation_____ wlaterial__ _______________________501 _ ---------------_ No. of co partments___ v:7 _ Capacity900G* Size__---&3 1 •D•:_Liquid depth-_- �f-"-------- Cesspool: Distance from nearest well_________________Distance from foundation .Lining material------------------------- _ ----------- Size: biam�ter Depth ----- Privy: Distance from nearest wel!__________________________ ______________________Distance from nearest building [] Distance to nearest lot line_______________________________ ---------------- ,. I 1 *� Seepag Pit: Distance to nearest well__-_110 -----_----Distance from foundation--------------------Distance to nearest lot INumone_____ _________ Field: Distance fr Pits--------Q�e-----Linin matorial_9ori* 131 Lining Diameter--_ Depth 20------------------------ Disposal ♦t om nearest well_�Q------------Disfanco from I foundation_--- ____• Distance to nearest toline___ _.0201 Number of,lines- --------On-e ----___--Length of each line----- 751_ _ __--. --- ----- - --rk __-_-_- _II --- .Type of filter materially ----- Width f --- ept flermaera describe):____-_______________________________ --------------- Remodeling and/or repairing -------------------------------------------- --------------------------------------r--------------------------------------------------------------------------------------------------------------------------------------------•----------------------- ---------------------I------------------------------ --------------------------------------------------------------------------------------------------------------------------------------•------------------ 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, and rules and regulations of the San Joaquin Local Health District. (Signed)_____D.A. Parrs : Sons, Inc. --------- ------ ------------ ----- (Owner and/or Contractor) By a ( ) President Y Title------------------- ------------------------------------ (Plot plans, showi g sae of lot, location of system in relat to wells, buildings, etc., must be filed with this application). 4 FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-l___----______ DATE_ -- - ? ---- REVIEWED 8Y----------------------------p--------- --- - -- -- -- _ ---------------------------=--------------------- DATE------------- ----- BUILDING PERMIT ISSUED------ -_--- "�- ----------------------------------------------------=--------------------------- DATE-------------------------- -- Alterations and/or recommendations______________________ ------------------------------------------------ ------- ---•- " -------- -------------------- --------------- ----------------------- -- --- ii--------------------------------------------------------------------------------------------------------•------- PERMIT No.----- ------- I�ISSUED---- -3 - / - (Date) FINAL INSPECTION BY___________ __ _ ------------ Date -- -•----------------i� SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street -ES-9 .2M 9-50 W-1639 Stockton, California