SU0010433 SSNL - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No. .I�_S;� (Complete in Duplicate) 1 Date Iscued ...4�ww ora- 23V�o7 . Application is hereby made to the San Joaquin Local Health District fora ermit to construct and install the work herein described. This application is made in compliance with County Ordinance N. J08 ADDRESS AND LO T(ON.�_ t1 A----•--- --- -----�` �. ....--• Owner's Na e---------- 1 .=-. - Phon •-----••--_... e-- /) �f j Address –�tadC.f +..� ` �_ .i�/.kc��G__.._ •4� _. cam. Contractor's Name...... ----•-•--•• ------- - - = Phone ._�f_j _Z.r Installation will serve: Residence �artment House [❑ Commercial ❑ Trailer Court ❑ Motel 0 Otherp Number of living units: --�_._ Number of bedrooms _1-9-umber of baths __./_ of size -----��_- A-Z G_t.ems/ Wa+er Supply: Public system ❑ Community system ❑ Private J9--8r6pth to Water Table :...._. ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy LoamClay Loam ❑ Clay❑ Adobe❑ Hardpan (] Previous Application Made: Yes ❑ No Q/_ ew Construction: Yes Lrd' tq,- ❑ FHA/VA: Yes No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS- (No septic tank or'cesspool permitted if public sewer is available within 200 feet.) 1 + '- ,S,eptic T Distance from nearest Distance from'foundation_-/. .--_-._-.Material--No. of compartments_� -------_.....Size,,U.NC_ �-..__Cpacit�y- _ .... - ._._• .!q------ depth----- � _ Disposal Wield: Distance from nearest welf�j�T�____:_prstan a from foundation__lQ- ..._•Distance to neares , Number of lines Length of each line__.I X Width of trenchC // ?Qr_ . - Type of filter material_ Depth of filter material__��fl-----___'-Total length................... Seepage Pit: Distance to neare t well._:______T_____`_Distance from foundation__""______-,____.Distance to nearest lot line...—__......... ❑ Number of pits__L-------___------- Lrning�material-•-•----•------••--:.Sizer:Diameter-----------------------Depth................. ___..._�._ �._. Cesspool: Distance from nearest well.......:.:......Distance from foundation.-'-'-' ............... material-----------____......._.....•__• ❑ Size: Diameter_.4--- _ - —.-Liquid Capacity-----. --------•-----------•----•- Depth-------•----._.... -• ---••--••-----•••----•--•-Li q --...._..._ als__.\ . Privy: Distance from,nearest well-------------- ____-------------------Distance from nearest❑ building__.:___.____----....-................ �1 Distance to nearest-lot line___s_-_____-____.____ __..................................................... Remodeling and/or repairing (describe)___________________ _.................... _ -'•-•-----•---•- _ _._�»-___...__.._.._._.._ _...._-- �.._.__.. ......................••-.......— L ( - - -_ ••--------------------••-••-................................-....................................----•------------.------- - I hereby certify that 1 have prep red this application and that the work will be done in accordance with San Joaquin Cou ordinances, 1fate laws, and rules and f regulatiohs of the n Joaquin Local Health District. Si sed A F.... BY--------•---___,-__..___..----•--•--••---.._` _._..._ ----••-••-••-•-•--:....._._. _. . ,, - . ..._. .. Contractor) (Plot plan, showing size of tot, location of system in relation wel s, buildin s, etc., can be placed on reverse side-- FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY------ _- -- ----- --•--- ----------------•-------------------------------------- DATEf-`--��.- -------....... _____•-_ BY.......................................*i---* _..-...._ __.__-._---_--_.___ DATE----._-______--- BUILDING PERMIT ISSUED..................- ---------_- - ---._--__-........................._.._. _. DATE............ Alterations and/or recommendations:____, -"--"•-••----=•=---•---------- ----- ........ ........... ............... ............................ INSPECTION BY: — -= Date _.. SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Stree+ 300 Wes+Oak S+res+ 131 Sycamore Street S+oek+on, California 814 North "C" Street Lodi, California Manteca, California Tracy, California ES-9-2M . Revises 1.57 F.P.CO.