SU0001347 - Laserfiche WebLink

Home Browse Search

. 4v Copy FOR OFRCE USE: ........... ............... ' ................."...................... ........... APPLICATION FOR SANITATION PERMIT Permit No. Y - ......................... . :...... (Complete in Duplicatal / . --. This Permit Expires 1 Year from Date Issued Date Issued a' Application is hereby made to the San Joaquin Local Health Di ct , r per it to construct and install the work herein described. Th,s applicator is made in compliant ty Or inane 9 r! MTCA Dom.. �' . JOB ADDRESS AND LOC 710 r��- r.3..±`t.1..... ........ ./..�..:�-=-c...... .. . . CSF.....� ._......._....... _ Owner's Name..-..-----_-..---- ' . OH .._.._. UF1gr=T..Ir.......................... ... . ...... ........................ Phone.................................... Address........:............./. ?.....�D......(: .Pa .r...........MTC.. ? ...._......_....................................... �. .......---- Contractor's Name._.CARG.L.L.F........................................................ .. Phone................................... Installation will serve: Residence 'Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Othor ❑ i- .F v •[dumber of living units: _.�.... Number of bedrooms •Z...- Number of baths _.J-.-- Lot size ... G=....................... SF Water Supply: Public system ❑ Community system ❑ Private Ir Depth to Water Table _ ft, f Character of soil to a depth of 3 feet: Sand Gravel ❑ Sandy Loam❑ Clay Loam❑ Clay❑ Adobe❑ Hardpan❑- ,. Previous Application Made: (If yes,dote....................) No 2" New Construction; Yes ❑ No � FHA/VA:Yes ❑ No r/f ' k TYPE OF INSTALLATION AND SPECIFICATIONS: y " (No sepfic,tank or cesspool permitted if public sewer is available wifhin 200 feet.) �z .' Septic Tank: Distance from nearest well.•.S1Q....•Distance from foundafion...—W........Material....COVYCAP-T-i ......... p 2-...........-SizC%3/X1.Q..X_.�._.Liquid depth..... .. .. .... ,ll��' "-4 No. of compartments L Disposal'Field: Distance from nearest well..-.5 ....Distance from foundation.... Distance o nearest _J_..:.... -� c t lot Imes �- f l b Numer oines.......... ...Length of each line--------.. r/'-�- .....-..... g /J.0...........Width of french....._.3.4......: Type of filter material. O.�"f`�..Depth of filte- material-----Zc.............Total length............/Zo.................•. Seepage-Pit: Distance to nearest well......................Distance from foundation....................Distance to nearest lot line......... :Q R p•f o Number b Numits......................Linin __De �. p;. p ❑ g material Diameter..............:...... pth......-•----............._._..._. � Cesspool" Distance From nearest well.................Distance from foundation....................Lining material..:...__................._ "') .......... ; t, ❑ DSize: Diameter ................. epth............................__..-•---••-------Liquid Capacity-••----.......-------. ..gals. Privy: Distance from nearest Well—--_ ......................................--..Distance from nearest building............................... _ e. - ] Remodeling and/or Distance ( doscr uslot line.................. ................ e . ............................"-.....:,..---.... ...................................... �s !•� ....................'.....�................................................_......................................".---------------- •--...------------'".•--............................................................. ._... 1 [.hereby certify that I have prepared this application and that the work will 6e done in accordance with San Joaquin County . ;�. ordinances, State laws, and ru�s end regulation, of the San Joaquin Local Health District. r (Signed)---- .y. .(Owner end/or Coefractorl`�.......... . ...... . ..... ........................ J By:.................................................... ....................... .................................._jTitlo) ............ ... (Plot plan, showing size of lot, location of system in relation to wells, buildings, efe., can be placed on reverse side). ~ y FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY..... ...T./ .• .....:............. DATE. S ` E S" ...............•.. DAT ...._.. i2EVIEWEDBY.................... ................... .................... DATE_............... .....:............._.........._....._,..'.. PERMITISSUED................................._................---------•-•---..---........_.....------.......... DATE...................... ........._ Alterations and/or recommendations:... _ ...... . s ............... .................. ... ....... ......... . ....... ... . f'. FINAL INSPECT10r� 8�;. V,--. ll'� . 1. !-{ .^E7.Z Fete.. .. .. 7....-., J Jam,• ' SAN JOAQUiN LOCAL HEALTH DISTRICT r 1601 E.Houlton Ave. 300 Weil Oak Sireet 124 Sycamore Street 205 Watt 9th street „ Stockton,ea Nfernio Lodi.California Marr+eca,Calirnrnia Tracy,California r.n cu