SU0006613 SSNL - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: FOR OFFICE USE: I APPLICATION FOR SANITATION PERMIT 7.g 90 . (Complete in Triplicate) Permtr No. .. rn + '---•........................ -- -- ThiW. s Permit Expires 1 Year From Date Issued Date Issued/ -_l6 �i )plication is hereby made to the San Joaquin Local Health District fora permit to construct and install the work herein described. F's application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: y�-- c �8 ADDRESS/LOCATION_...... .. - .J --..... ? C.....-�,..�.i......( ! .....-.CENSUS TRACT. ...-.. r•+vner's Name... . ...................................... ..• ---- ••----...... --------- ...................- � f.-� . .............................:........Phone i t sS....- - --------- - V. ......�-I S. .U- ......-city---06-5 ..... ---••----Zip•-q ra�ctor's Name---._....._.... � _ - .d..►' ----•--- t'�_ ------------------ #.J:2ey7-� Phone-- - `� ,tall ��.t1..7'..-...-...��-- ntr cation will serve: Residence Apartment House.❑ Commercial ❑ Trailer Court ❑ Motel p Other............... .,mber of living units:.... ........Number of bedrooms r7 ------Garbage Grinder.------ •---Lot iterCSupply: Public System and name........-___•------------------ b ' 4 Private ' arae) er of soil to a depth of 3 feet: SandX Silt❑ Clay ❑ Peat [] Sandy Loam ❑ Clay Loam ❑ i r Hardpan [] Adobe ❑ Fill Material...........-If yes, type__...------ 'J)t p4an, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side.) :W INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) :CKAGE TREATMENT [ J SEPTIC TANK .[ Size.......-.. r 1 �.26-iti--------•- -----------••---------Liquid Depth..,,---�-----'.._. 1 Capacity. _{t._�t' Compartments.-�-..- Distance to nearest: Well........- /_{]._e ! ----_-----•f=oundation-----r_O'�`. •prop, Line... _Q. G kCHING LINE [ J No. of Lines... ------- -...-----••---------- .ength off ea� nk�"--...�b----��---------._-:Total Length.--...��----------------------- OC „-. Material- --3....---..-.Depth Filter Material...-."-�--fi�----�-s---�- --•-----------P r i Distance to nearest: Well. /� Box.-- ..-.-._.Type Filter -�..-f '•-....Foundation . 1- --.._..Proper#y Line_. ._- .---------•-- i _:PAGE PIT i l Depth......... Diameter. Number. :.. Rock Filled Yes ❑ No 4 Water Table Depth.........................................................Rock Size.............. - r , Distance to nearest: Well..................... .. -_......Foundation......--........--------. Prop. Line................ ........... 'FAIR�/ADDITION (Prev. Sanitation Permit#-----•---------------------------------------------Date........... - .. r-9tic Tank (Specify Requirements). ........... Field (Specify Requirements)............. . ------ ..................... i ............. - - I' --....:........................... ' (Draw existing and required addition on reverse side) tereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County mlinances, State laws, and Rules and Regulations of the San Joaquin Local Health District. Home owner or licensed agents ature certifies the following: — f certify that in the performance of the work for which this permit is issued, I shall not employ any person in such manner'as 'becomes le t to Workman's Compensation laws of ,California. - ---•----•----....----•.........................Owner ,.-... L�- ..........RPA-Oho-................. .. .Title-------- --------------- i (If other than owner) FOR DEPARTM E ONLY rLICATION ACCEPTED BY.------ .." . ..... -.- --.---:_---• --------_--. .-DATE. � .1�_ �. �iSIQN OF LAND NUMBER............. . ....... -------._._.DATE... .- ...._ )DITIONAL COMMENTS..................... k ........................... . ......................... .......: ------.....--------.-------••------- --------•--------------------...----------------..---. -.- ---::---- ----- .............------------... - � = ial Inspection -- ------.Date.. ....-- 24 j SAN i0AQU1N L CAL HEALTH DISTRICT F6s 21677 eev. 7?76 sas h