75-444 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: APPLICATION ICOR SANITATION PERMIT 3 ................... �. .. [Complete In Trlpiicahly Permit No S .. ....................... This Permit Expires 1 Year From Doh Issued Date issued .......... Application is hereby made to the San Joaquin Local Health District for a permit to constnict and install the work herein described. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulotions: 4814 E.�3rd . : 308 ADDRESS/LOCATION .. CENSUS TRACT ,a ........ .-•-•-•- . ............... ...._ Owner's Name .....Mr9..Martha Guerra _ ......... ............................. .......................................Phone 4.Address ..._ 811... E. 3rd. :...._. ..'City' :.. ...:.. :_.. ..... --- Cantractor's Name ..........Ra#,o Rio er e Y ..... ...... .................license# _2.7-1_5a. 9....... Phone4.65 .2-616•- Installation will serve: _ Residence EFApartment House C] Commercial OTrallor Court C] Motel ❑Other .:: Number of living units:-A....... Number of bedrooms ...... .............. . Garbage Grinder .Ye 5... Lot Size 25..x...100 Water Supply: Publics stem and ....._.... Calif:.Water: Sex,vice _..-..---•---`^--------...:.:...... System name .Private Q. Character of soli to a depth of 3 feet: Sand t3 Slit 0 Clay 0 Peat❑', Sandy loom.fl Clay Laam Hardpan 0 Adobe 0 fill Material.no.....If yes,type............... . (Plot {clan, showing size of lot, location of system in rotation to wells, buildings, etc. must be placed an reverse sl loj NEW INSTALLATIONt (No septic tank or seepage pit permitted if public-sewer is available within 200 feet,l PACKAGE TREATMENT I } SEPTIC TANK{ ] Sire.................. ..... .. Liquid Depth± Capacity ...a..............._ Type.. . .......... Material..... ....... No. Compartments ...... sDistance to nearest: Well :.. .......:.......r......... .Foundation .. ............... Prop. Line.....................r LEACHING LINE ( j No. of Lines ..................... Length of each line............... .... Total Length ........................... D' Bax Type Filter Material ..'Depth Filter Material ............. Distance to nearest: Well ....::.................. Foundation .........::..._......... Property Lithe ........................�1 SEEPAGE PIT 1 Depth ... Diameter , Number .....r..........................Rock Filled Yes [3 No 01 . Water Table Depth ................................. .. e . ...Rock Si Distance to nearest: Well ..:...............Foundation ..._... Prop. Lino .......... ......... REPAIR/ADDITION(Prev. Sc3nitation Permit` �T....:.....::.. Date :f.:::1 .. --:l Septic Tank (Specify Requirements)...... dd a 101 . le ach line and 1-, " �y 2��,.'--_p, _....................... ....... Disposal Field (Specify Requirements) ................ .................. ......................... :.:.....................:.---........ . ...................................................__............_._..__•-------•_•---..............w................................_........... ...... ............................. (Draw existing and required addition on ieverse side) . 1 hereby certify that 1 have prepared.this.application and that the work will-be'done in accordance wlih San Joaquin County Ordinances, State Laws, and Rules and Regulations of. the 'San Joaquin Local Health,District. Horne owner or licen- sedagents signature certifies the following: "I certify that in the performance of the work for which this permit Is issuer!, I shall not employ any person In such manner as to become subject to Workman's Compensation laws of California." Signed ...... ......................---•-.......----------------------........._..._.__. Owner BY ......... ----------_-J.QE.__T�hit.s:. ................ Title :. an-tr.ac--ta2r1......... _...._.._.........•...._._...._ (If other than owner) _ FOR DEPARTMENT :USE ONLY APPLICATION ACCEPTED BY ..... ...................... -- • ................r.-..:----.-._...------. DATE.. ._ ..x.. -..7 BUILDING PERMIT ISSUED __._._.:............................ ----•---.. _..-•--------------.........................................DATE - -........................................ ADDITIONAL COMMENTS .................. ................................ ....................... �_................................... ...._.. : ` . --•-•- •- .................................................................... ... ..... :. ..._ ........_.._....... .................... ................... ........ ...... ...... Final Inspection by: ............. Date .. ... ... /�. ... . EH 13 24 1-68 Rev. SAN U LOC t HEALTH DISTRICT 8 74 3M