7964 - Laserfiche WebLink

Home Browse Search

(r APPLICATION FOR SANITATION PERMIT Permit No. -----2fA.`-L. (Complete in Duplicate) " Date Issued Application is hereby made to•the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. a JOB ADDRESS AND LOCATION-------- r�+ � + ----•---- -------•------------------- r Owner's Name------ �* J a BOyC -------------------------•--------------•-----•-------------- ------------------------- ----- -.-- Phone.-H---- r---------��4-... k fNddress---------------_.ga Il e--------------------------------------- -----------------------------•-•---•----------------------------------------................ ---------•------------------------- Contractor's Name---------DeIl�-----------------------••- -----------------------------•-• -----------------------------------------------•........ Phone --1269------ Installation will serve: Residence ❑K Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ I Number of living units: -1----- Number of bedrooms _--2_. Number of baths I---_ Lot size -------�9 X_-.1-0-0 -----------------•- Water Supply: Public system FLI Community system ❑ Private ❑ Depth to Water Table 40--- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe[3 Hardpan ❑ Previous Application Made: Yes [] No E�: New Construction: Yes ® No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well_________________Distance from foundation-------------------Material_-_-_-_____._-_____________-__-____-_--__.. Exisffl!Lng No. of compartments----------------------- --Size------------------ - -- -- ---Liquid depth--------------------------Capacity----------------------- Disposal Field: Distance from nearest wet—-------------Distance from foundation--------------------Distance to nearest lot line-_____-____---•_ Exisging Number of lines---------------------------.-------Length of each lin ----------------------------- of french________._______._____..___.____ Type of filter material-------------------------Depth of filter material-----------------------Total length___.__________.___-.__----_-__-__---_-__-- Seepage Pit: Distance to nearest well----nP------------Distance from l foundation.-�-9_______._..Distance to nearest lot eine__5------------ ® Number of pits-.-----I------------Lining material---Y'OCk--------Size: Diameter-----�0__.._...--_-Deptn_-_25________________________ Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material__..-_________--__---.---_-_--_.-... ❑ Size: Diameter---------------------- ---------------Depth----------------------------------------------------Liquid Capacity.---------------------------gals. Privy: Distance from 'nearest well-------------------------------------------------Distance from nearest building------:----------------------------------. ❑ Distance to nearest lot line------- = '---------------------------------------------------- --•------------------------------------------------------------------- Remodeling and/or repairing (describe)______________ ,ed_-..qei$ & ,-,pit___to____exist n� ----s-entla---ay-s-t-em--------•------------------------------------------ --------------------------------------------------------------------------------------------------------------------------------- --------------------- ------------------------------------- ----------------------------------------------------------•------------------------------------------------------------------------------------------------------------------------••------••--------------------------------- I hereby certify that I have prepared this application and that +he work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. tP911fk------------------------------- - ------------ ---------- ----------------------------------------------------------- Owner and/or Contractor By:------ •-----------------------------•-•-F, rry Warthan ----------------------------------- -----(Title).....Gen. mgr (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY---------------------------------- ----------------------------------------------- ------ DATE--- --- -- REVIEWED BY ------------- -----------------b----------------- ------------ DATE-- -- --,-- ¢ { -� BUILDING PERMIT ISSUED------------------ ------------------------ ----------- --------- ------------------------------------- DATE---- ------------------ .�----------- --- Alterations and/or recd jendationns- - ------- - ----- ------- ---•-G--------- ---------------••---•--------------•------------- L- -- -------------------------------------------------------- -----------------------------------------------------------------------------------------------------------------------------------------=-------------------------- ------------------------------------------ ---------------------• ------------------------------------------------ ---------------------------------- -----------------------------------------.•----------------------------------------------- FfNAL INSPECTION BY___ __ ______ __ -------------------------- ------------- Date......:_ --------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C' Street Stockton, California Lodi, California Manteca, California Tracy, California rs-9- 2m 145446 ATWOO❑ 12-54