Laserfiche WebLink
FOR OFFICE USE- <br /> ------------- ------------------------­1-- --- -------- <br /> APPLICATION FOR SANITATION -PERMIT Permit No. <br /> ..............7----------------------------------------- (Complefo.in Duplicate) Date issued L <br /> ---------------- --- --- ------------------------- This Permit Expires I Year From Date Issued <br /> Application 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 n-vde *lia withCounty Ordinance No. 549. mrcjq�7ti <br /> �v i-e-J ------ �*F--------WOOPWAKC>............... <br /> JOB ADDRESS AND LOCATION----- 7--------- <br /> Owner's Name-------- -------- //---------------------------------------- ----- ------ --------------------- ---- --------------------- Phone.-_ _1413-W-2-Y---- <br /> Address----------107-1--------- --------------_----------MANTJF�ZQ... -------------------- ------------------------------------- <br /> Contractors Name-----ffd "((------------------ - ----- ---- ------------------------------------------ Phones k? 3 ------ <br /> _/n------- <br /> Installation will serve: Residence Apartment house [], Commercial 0 Trailer Court [] Motel Ej Other E] <br /> Ir <br /> Number of living units: Number of bedrooms -3---- Number of baths ---1_ Lot size ---- P_-_.------------------------ <br /> Water Supply: Public sysferTi. E] Community system El Privafegf Depth to Water Table ------ - ft <br /> Character of soil to a depth of 3 feet- Sand's Gravel E] Sandy Loam Ej Clay Loam 0 Clay [] Adobe [] Hardpan 0 <br /> Previous Application Made: <br /> _No. _.New_Construct.ion.: Yes-99"—<o..E]-;�--FHA/-VA:-Yes-R' No-[ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well----.�?-----Distance from foundation-_10----------Material _---CS A/ f;2 44�- <br /> ------------------------- <br /> No. of compartments------- i------ ---Liquid depth------4� . ... ...Capacify._Z__�C---------- <br /> Disposal Field: Distance from nearest well...67P_ --Distance from foundation-----1'.®_-.---.-.Distance to nearest ]of line------------------ <br /> e) <br /> Number of lines---------1.14, --------Length of each line_ ___.--_-.-.-.Width of trench-.__ ------------- ----- <br /> _ --- <br /> . f...... <br /> Type of filter material . . .. <br /> __r'A—�­_Depfh of filter material--_ Ir <br /> _Z7 Total length_____- ----------------------- <br /> Seepage Pit: Distance to nearest well---------------- Distance from foundation--------------------Distance to nearest lot line__--_-------__.._ <br /> ❑ <br /> ine----------------- <br /> ElNumber of�pits... ..............----Lining material--------.-- --- --- Size: Diameter-- -------------Depth--------------------------------- <br /> Cesspool: Distance from nearest well ________________Distance from foundation.___.;____.._ <br /> --. _Lining materia l------------------------- ------------ <br /> El Size. Diameter- ----------- ----------------Dept h- -----------------------------------------------..-,Liquid Capacity-------------- ------------•gals. <br /> Privy- Distance from nearest well---------------_----- ------- -----------------Distance from nearest building_-_-._-___.._---_---------._--.-. <br /> Distance <br /> uilding-----------------------------------Distarce to nearest lot line ............... ------------------- ------------------------------------------------------------------------- ---------------------- <br /> -Remodeling and/or repairing (describe):-- ---------------------------------- ------------------------------------------------------------------ ----------------------------------------------- <br /> -----------­­­------------------------------------- -------------------- ---------------------------------------------------------------------------------------------------------------------------- - -.-- -X <br /> ------------------------------------------------- ---------------------------------------------------------- ------------------------------------------------------ -------------------------------------------------------- - <br /> ----------------------- - -----------------------'----------------------- ------------------------------------------------------------------------------------------------------------------------ ............ <br /> I hereby certify that I have prepared this application and that ther work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> ---(Signed)-------` '=" _,Ao <br /> ­­ I----- ­-------------------- --- -­_­.... .. (owner and/qr.Contractor) <br /> By:------------------------------- ----------------------------(Title)------------------ ------- -- - ----- ......I------------- <br /> (Plot plan, showing size of lot, location of system in relation .7 to ells, buildings, etc., can be placed on reverse side). <br /> FOR 9WARTMENT USE ONLY <br /> APPLICATION ACCEPTED 13Y.- -------------------- - ---------------------------------------- DATE---- 41---------------------------- <br /> REVIEWED <br /> 10----------------------- <br /> REVIEWEDBY-----------------_------------------------- ._------ -------------------------------------------------- ----------------- DATE-------------------------------- --------------------------- <br /> BUILDINGPERMIT ISSUED---------- --------------------------­--- --------------------------------------------------------- DA-TE------------------------ <br /> Alterations <br /> ATE------------------------Alterations and/or recommendations:- -------------------- ---------------------- --- -------------------------------- ------------ -•--•----------------- -- ---- ----------------_-------- <br /> ------- ------------------------------- ------------------ ----------------------- ...... ---- -------- ------------------------- -------------------------------------I- --------------------------- <br /> ------------------------------ --- ------­-------------------1-1--------------------------------------------------------------------------------- ......­------ -----------------• ----------•-- <br /> -------•----. ----- <br /> ------­1--................... ----------------- .......... ------------ - ------------/?-- - - -------------- ............ -- <br /> -- -------- - ---------------------------------- --------- -------------------- <br /> 4- - -- -- - ---------------------- ----------------- ........... ------ ------------------------------ <br /> ------------ --------------- ------- -- . ..... ....... _z A <br /> Date- - - -- <br /> FINAL INSPE N BY D .41------------------------------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E.Hazelton Ave, 300 West Oak Street 124 Sycamore Street 205 West 9th Street <br /> Stockton,California Lodi, California Manteca,California Tracy, California <br /> E.H.9 2M 1-67 Vanguard Press <br />