Laserfiche WebLink
IT Permit No. <br /> APPLICATION FOR SANITATION PERM Date Issued <br /> Complete in Duplicate) <br /> Applica",ion is hereby .made to the Son Joaquin Local Health District for a permit to construct and 'install the work herein described. <br /> This application is made in I.cornpiiance with County_Ord;nance No..549. ee_ --------------- - <br /> This <br /> —------ I-----------j��­------------- <br /> JOB ADDRESS AND LOCATIO ---------- -------- ... ZC V Phone-------------• <br /> 1_, -fes <br /> hone----------------------------------- <br /> ....... .......----------- <br /> -------------- <br /> .. -------- <br /> -Owner's Name-------- -------------- -- ----- - ------ <br /> -------- ----------- -- --- - --- ------------------- <br /> Address--------------------------------------------- ----- ------- ----------- ------------------------------------------------------------ Phone---_----------- <br /> Contractor's Name------------------------------------- ------ --------Co-m-mercial ❑0 Trailer Court,[3 Motel 0 Other 0 <br /> - Residencej&_ Apartment House E3 �5x_�47P------------------------- <br /> installation will serve..n' units-. 1--- Number of bedrooms %-?-- Number of baths.--/--. Lot size --------7, <br /> Number of living Community system ❑ Private K Depth to Water Table -------- ft. <br /> Water Supply; Public system 0 COmmu Sandy Loarri;Eg, Clay Loam El Clay [I Adobe❑ Hardpan 0 <br /> Character of soil to a depth of 3.feet: Sand Fj­Gra'v'�eI,rj <br /> �N' g,; New Construction: Yes No 0 <br /> Previous Application Made- Yes 0 0 4 <br /> TYPE OF INSTALLATION AND SPECIFICATIONS-. <br /> i 1 200 feet.)­�i. <br /> "'Iavailable -7 ....... <br /> (No septic tank or cesspoo Rermitted if public sewer is <br /> Di tance from foundation---- Material---- <br /> ------- Is �4'0-------Capacity-- <br /> Septic Tank: Distance from neareST well_, �g 3 Liquid depffi--- - -------- <br /> No. of compartments"_.___--- <br /> Size-----` --------- <br /> - -------Distance f-rern foundation-------le) ---Distance to nearest lot line <br /> X rest well-- trench -------;4f ---------- <br /> Disposal Field-, Distance from nearest J-11 Leng�hzo; each line-----"-----------------------Width of frer ...... <br /> ---------------- -- ----- ------------J_Z4------------- <br /> Number ci� lines.- <br /> r A _� D ­ h of filter maternal__- -------Total length-- <br /> -•-------------OT filter material_�,,� -L-4.4 60 <br /> 'dc <br /> from foundation-_____.__--------------------Distance f6 nearest lot line_________________ <br /> Distance.to nearest weli----- ------------- ---Distance Depth------------------ <br /> Seepage Pit Number of pits-------•---------- ---Lining material---------------I----- . ..Size: Diameter-------•----- -I----------------- <br /> Ejfoundation------------------Liquid <br /> - -------Lmaterial----- <br /> rom nearest well-- ----------Distance from foundation---------- -- ---------gals. <br /> Cesspool: Distance.f -, I ,--1.- , .epfh-----------------------------------------------------Liquid .Capacity_------------------ <br /> Size: Diameter- , - - ----------------------------------------- <br /> 0 '-'. Distance from nearest building <br /> Distance '�rorn nearest well------------------ -------------------;--------- ------------------------------------------ <br /> ----------------❑ --- <br /> Privy: <br /> Distance to nearest lot line__-_� -------- ---------------i-----•---I <br /> --------------- <br /> ------------ -------------- -------------;-------.-----"-------­­­-- --. ------------------------------------------------------------------------ <br /> ---------- -----------------•----------- <br /> .' <br /> ----------------I---------------------------- <br /> - I -- 7 ---------------------- <br /> Remodeling and/or repairng4(describe)------;---------- ----------------------------- <br /> --- ------ <br /> - <br /> - <br /> ------- -------------------------------------------- ---------------------------------------------- <br /> ------------------------------------------------ --------------------------- <br /> ------------------------- <br /> ----------------------------------I-------------- ----------- ---------------------------------­-------------- <br /> --------------------�n­-------------------------------- ------- will be done in accordance with San Joaquin County <br /> I hereby certify that I have preparii�d`this application and that the work <br /> ordinances, State laws, and rules and re%gulations of the I San Joaquin Local Health District. <br /> .am --- -------(Owner and/or Contractor) <br /> --------------------------:------------------------ -- ------------------------ ----- <br /> ---------- <br /> (Signed)X---,?,,41 !2 .­� - ---------- ------------------ <br /> --------- fie)------------------------------------ <br /> -------------------- -I----- ­(Til <br /> By:--------------------------•------------------- in relation to wells', buildings, etc., can be placed on reverse side). <br /> (plot plan,'sh-owing size of lot, location of system <br /> FOR DEPARTMENT USE ONLY <br /> A <br /> DATE------------- <br /> --------------­----------- -------------- <br /> ----- --------------- --- -- - ----- --------------­:--------------- .............. <br /> APPLICATION ACCEPTED BYYr'-.' DATE------------ <br /> --------- <br /> Y - - ----------------- ------- <br /> --------------- -- --------------------------------------------------------------------- <br /> REVIEWEDBY-----------------------­ ------------------------------ DATE------------------------------------------------- ---------- <br /> P SS ------------------------------------ <br /> -- ------------------- <br /> ------------------ <br /> BUILDING PERMIT ISSUED._-.-.-------------- ------------ ------------------ <br /> ---------------- <br /> --------------------------------------------------------------- <br /> Alterations and/or rec;mmendations:--------------------- ------------ I _. <br /> ----------------------------- --------------­ ------------------------- <br /> -------------- ---------------------- <br /> ----------I----------------- ------------------------- ------- - ---------------------- ---------------------- <br /> ---------------------- ------ -------j----------------------------------------------------------------------------------------I-------I ----•------ - -------------------------------- <br /> ------------------ -------------------- - --------L--------------------- -----------------------------------------------........ <br /> ------------------------------------I------------------- ------------------------------------ ----------....... <br /> --------- ----------------I---------------- <br /> ---------------------------------------:_1-------------------------- <br /> --------------------------------------------- --------------- -------- --------- <br /> —- ---------------------- Date-- ------------------------------- <br /> FINAL INSPECTION SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 132 Sycamore Street 814 North "C" Street <br /> 130 South American Street 000 West Oak Street Tracy, California <br /> I Lodi, California Manteca, California <br /> Stockton, California <br /> . . I F, W-.71nn 4 — --------— <br />