SU0004494 SSNL - Laserfiche WebLink

Home Browse Search

............... er ......................................_...._...... P"OLICATION FOR SANITATION PER' "TPermit No. .ct f see............................... _..... . 'Now (Complete-in Duplicate) `/ Date Issued _................... ............ _. This Permit Expires 1 Year From 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 c ornnce with County Ordinance No. 549. L/ / JOB ADDRESS A D LOC t tS �1�A...RT-- - T� �.Z.F.--..1L�I...._�� ...-------- .......Owner's Name.... /�pAD-:5...... V— �........... L�L(-.�... .-------_ _ .... ...................................... Phone.._..._............................ Address...............�K�.. 1........--.)! t..._.....r.Pt��A..�.T.........171.>---_................./ .j.4_PV.P......_.........................._.....__..I.. Contractor's Name..V.W./.F1`7.'�.-.._..................... .... - -- ...---- . - ..... ...... _......_..._ Phone................................... Installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court [►�Motal ❑ Other ❑ Number of living unitss3.... mbar of bedrooms .�.... Number of baths..-. Lot size ./� - A.�Z ........................... Water Supply: Public system Community system E] Private Private ❑ Depth to Water Table �D- - ft Character of soil to a depth of 3 feet- Sand Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe❑ Hardpan 0 tel. Previous Application Mede: (If yes,date................... I Noll�New Construction: Yes9ENo ❑ FHA/VA: Yes ❑ No TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic T Distance from nearest well------5 _Distance from fouuf dation._...._/-....Material CONCRIP rr No. of compartments...-. ......._....Size.,6.K17.X. ..?......Liquid depth-,-.5,; Ca pacity..rl.�5,r.P.. Disp^os�al F' td: Distance from nearest well.. .....Distance fromfoundatiggpp....1Q........Distance to nearest lot line j.�5......... LAS Number of lines.......... ---------------------Length of each line_--1i!Q.........ry-----Width of trench---- _AP. . ..-...t...... — Type of filter material---1?0 5%.....Depth of filter material......rZy. .......Total length..................... Q....---------- Seepage Pit: Distance to nearest well......................Distance from foundation....................Distance to nearest lot line................. ❑ Number of pits... ..................Lining material.--................... Size: Diameter.......................Depth............................ .--_� ` 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)%------ ..... - -......... ............................... ...........--•---......•.----------....................... .....--............... . ..........-........-...........................__.... _••--•-_....._.............•------...............--•-••`------_.................. -......--....... ........................................._.. ------....-- -------------------------•.................................................................. ... .................................. -........_--.....-----..........._-------------- .------ -- ......----...-----------......-------.....--------...... -----........-------..........-..... ........ -- -------- -..............................----------------- U I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County e ordinances, State laws, a les and regulations of the n Joaquin Local Health District. (Signed)...-. - ,..'.-__... ............ _ -.._- -- ...----..---(Owner and/or Contractor) By:................................___ ---------------------- --------------------------...(Title)--------- ------ -... __._......... .. _...... (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTM NT USE ONLY APPLICATION ACCEPTED BY---- ..�T.R>&-r-.......... - - DATE..,....L9�-:ZI-67. ...... .. - REVIEWED BY........... - VQ.ND R-.HA FT -------------------- -._................. ........ DATE.-....l..-Z..--.6Z....-.._..- ...... BUILDINGPERMIT ISSUED........ .. ---... ---...... ......._........_.....................--- . -- ............_ DATE......................................................... Alterations and/or recommendations:-------------- ----. --------....._........... ........................ ......................................................................-------- ...........................--.....---..........................................---------....................._.••--•............ -. .....- ................... ----------------........................ Y,. ...-------.---------.---------- .......................................... ............................- -` .....................___................. ..........................................------........... _..... . ................................... ....... ............_............. - ... ... ... . ....................-----......................................................... ........ .................. I` FINAL INSPEC�i9P1 BX; -- - ._........ ... Date.....--.._.......f ." (�. SAN JOAQUIN LOCAL HEALTH DISTRICT V 1601 E.HasoHon Avis. 300 West Oak Strut 124 Sycamore Street 205 West 9th Street Stockton,California Lodi. California Manteca,California Tracy,California E.H.9 2M 1.67 Vangeard Prms