13959 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No./r� N 1,i .}53 (Complete in Duplicate) Date Issued F n= _ "Application is hereby made to the San Joaquin Local Health- la permit to construct and install the work herein described. ` This application is made in compliance with County Ordinance No..549 } .,. Out Waterloo to 8ny_ders rt, and JOB ADDRESS AND LOCATION-A�_- P--.-HOX 925 i� Stki n, 4th hs.' on rf, -----------------------------x - z-695a- Owner's Name------------------ AObF;rt Harford ---•----------=--- ----- ----- --- -- - --- Phone. ------------------------------- ----------------------------- 6- -------------------------•--- -------------------- }- :_ L * r r rv�.ce Inc. . At l Box 314 ZT LO( CaY f Address------------ --• --- - - -------------------------------...-------------� -----------------------------•----------•------- Contractor's Name Ael-ta- -�g--eR1 �'C Falk std ---i. *----- ---c° - ----------- ------ Phone..H�-------��12�q---- �Installation will serve: Residence ;E] Apartment House ❑'• Commercial ❑ Trailer Coin# ❑ Motel ❑. Other ❑ k. } 2 Acres Number of living units: -.---- Number of bedrooms --- Number of baths - '- _{Ubt size ------------------------------------------------------------ Water Supply: Public.system El' .Community system❑ ' Private-E3 . Depth`to Water Table �5--- ft. 1-4 Character of soil to a depth of 3 feet: Sand E] . Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe [A Hardpan'L, Previous Application Made: Yes ❑ No*]] ', New Construction: Yes �;'�N�❑ FHA%VA: Yes ❑ No F] TYPE.OF INSTALLATION AND SPECIFICATIONS: ` f = (No septic tank or'cesspool permitted if public sewer is availablefwithin 200 feet..) f Distance of compartments rcare ___--ell--_; Distance from foundation--------------------Material--------------------------------------------- Septic .-_.. 5ize--------- Liquid depth----•--------------------Capacity-------------------•--- Tank: Distance from nearest well_ ED s o'sal Field: Distance from nearest well. Exi 4 in Number of lines----_�_:__-:_-�_:_._------ - 'Dista�ce from foundation---------- ------.Distance to nearest lot line----_._-.------_- _ . .,, � Length of each line--------------.--_---- Width of trench----------------------------------- Type ------ ---------------------------Type of -filter matefial '"_ -'-----------------Depth of filter material--:-------- -Total length------------------.----_----._------------ Seepage Pit: Distance to near -� -'-Distance from foundation"`: t „ .i Vince to nearest lie_ ,-_ Iq'Ck -- ---Depth- �7 Number of pits------ --"---------Linn raterial_______________�s___.-5ixe: Diameter----•-..------------ Cesspool• Distance from nearest well---------------`Distance from'foundation_--__.-_----.__-.Lining material_-.-_-_----_--_.---____.---_-JI.s ❑ 'Size: Diameter-------+---- --------r-1 i -T ==Depth---------�-- =--------`-- -==------ Liquid Capacity---------- ---- ---------- F ;. e ----------------f-_-..Distance from nearest building------------ ;------------• Privy: � Distance from nearest�d�elL----- ---------------------- ❑ ° Distance to neares of line-.-- -"- ---------- ---`---------- -= =----------w- -------' i= - •� i . dd n Filter.- Bed to existing system ° Remodeling and/or repairing (descr.ibe):_---�`------ ---g-°--- -- -------•-----------------••;.it,f_ ,� .� °7 -( ----------•----- --- - ---------- -----------•-------------- ----- =------------ 4 - -------------------------- ---------------- --------------------- •------------------------------- ----•--------------- ------------------------------ --------------------- 1. , - :? ;.r y t .-- J _ .�' i herebycertify that 1 have re ared fhis'a lication and that the}work will be-done --_-- -------�-_-_--n - - -- ------- f - -- --- - ----- ------------ - -=--- ., �., } y p� p pp ne in accordance`�w� h San Joaquin County ordinances, State laws, and rules and regulations-of the San Joaquin Local Health District. )� n 'P :c-ei jbAe ------ ----------------------------------------- (sign --------(Owner and/or Contractor) fied - � ---D lea---dentin.-_T 13 -—A oW of loca#io zsf s - +� } !.J i ; C3en. Mg r d r ghowin -_'--------- --------------- - --------------------------(Title)-----------•------ ------------------ --------------------- {Plot plan, g E `� _` ystem in relation to wells, buildings, etc., can be placed on reverse side). ' . ,b 9;A.?')„9(t i 'FOR DEPARTMENT USE ONLY i -------------------------- DATE--- APPLICATION ACCEPTED BY REVIEWED BY DATE BUILDING PERMIT ISSUED - - -�-- 1 DATI= _ tiA�l�teratns and/or recommendations---------=-------------------------------- --•-----------=-•--`------ --..-•-------.--•-------=----•- ------------------------------------------------ 7 ---------------------••-•--------------------.. ---------------f ----------------- -------- ----------"-----------1------------------- _.--•-•_.---•---.---.-----_----_.------»..--_---------.----•--. •---_---•_-- --------------------------------=------------- ----- -- - --- --- FINAL INSPECTION BY:-_{ - ----------- - - --- ` --------------------------- Date-------- - - ----- - ----------- ` ..,. ,USAN JOAQUIN LOCAL HALT STRICf- ,3 3 i r Y /°§ ^ �S }- 132 S camora St 814 North "C-° Street 130 South ` rneneannStreet is 'V 3Go est Oakk Street-„} >a e �7 Y, ,{ t)� "" I t Stockton, CaliFornie Lodi, California Ma0.0.nteca, CaliforniaTreey, Caiifor'nie ES-9-2M , Revises 1-57 FY.CO.