SU0007428 - Laserfiche WebLink

Home Browse Search

FOR OFFICES USE: APPLICATION FOR SANITATION PERMIT c G - 7------------- Permit No. _(4fJ.�'.7. l ---- ---- ------------ -- (Complete in Triplicate) Date Issued - This Permit Expires l 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 compliance with County Ordinance No. 549 and e ' ing Rules, a d Regulations: /� c- JOB ADDRESS/LOCATION ..yCLl1..CL--- ---- j' e0L --- - - ---------CENSUS TRACT 1------------------------- - ------- _9- Owner's Name ------- --------------- --•- ------------------------------------------Phone ........ Address ------ 10 / ------ CffLl ° Contractor's Name ------- License # B---j-S 3- 3.� 'hone .. . ��b - Installation will serve: Residence ❑Apartment House)=] Commercial❑Trailer Court Motel [3 Other...--oeW✓k -/ ..........71-1,5W1-,c4- - Qb aPer Number of living units:------- ---- Number of bedrooms ------------Garbage Grinder ..--._.... Lot Size ------/_:3.. __c---..---- Water Supply: Public System and name .------------ ---------------------------------------------------•-------------------------------.. Privavl..., Character of soil to a depth of 3 feet: Sand ❑ Sil�gr Clay E3Peat ElSandy Loam C] Clay Loam wf}} Hardpan ❑ Adobe A Fill Material -..-_ ---- If yes,type .---.-_-.-._-..-----.----\ (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side.) NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) PACKAGE TREATMENT [ I SEPTIC TANK I ] Size...-------Z0.4-Prz yil . _ Liquid Depth ------ `-_............. Capacity .-6ao_o------ Type --------- No. Compartments .---4....-..... ---• Distance to nearest: Well ------;;'A4_ ---------- ..........Foundation .e..Y'r!2�._.. Prop. Line .....$..._.-.-$.- LEACHING LINE [ ] No. of Lines ---.--b7-----------_- Length of each line-----/-A..O--------------- Total Length ----9-°-a................ !/ 'D' Box P.,-G.,.-. Type Filter Material SrrVjtt# -.fspth Filter Material -.---- �.............................. Distance to nearest: WellFoundation Property Line ...l-sa-'......... ,„- 1 11 SEEPAGE PIT [ ] Depth 157, --- ----_ Diameter -)-.iL.-..-._.-- Number ._.-.--...-..._..-._..- Rock Filled Yes ® No D Water Table Depth _.__ --- b r------------ --- --.---.Rock Size .----aye-..-. ----------- - --- - Distance to nearest: Well .__.}�.¢4 ✓___�. ......-..--Foundation _a-k!tk../&.)Prop. Line _..1.P f_'.-.--..-- REPAIR/ADDITION(Prev. Sanitation Permit# -------------------------------------- Date ---------------------------------I Septic Tank (Specify Requirements) ------ -----6_'ws�. .._ �s _ __`:O.tv -------------^----,------------------ ------------------ �Q Disposal Field (Specify Requirements) ------- - - - t' ---------------------------------------- ------------------ ----------- ------------- --- ------------------------------------------------------- ------------------------------------------------------'------------- ---------- ---------------------- -------- --------------------------------------------------------------------------------------------------------------------------------------------------------------------- fDrow existing and required addition on reverse side) 1 hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local Health District. Home owner or licen- sed agents signature certifies the followi'ngi "I certify that in the performance of the work for which this permit is issued, I shall not employ any person in such manner as to become subject to Workman's Compensation�laws of California." Signed ...... - ----e----------------------- Owner By ----------------------------- --- ------------ - -------------- Title ... --- "`E1 - (If other than owner) DEPARTMENT USE ONLY APPLICATION ACCEPTED BY _.. - - - - - DATE ��=�f{`v(f`' -- ---- PERMIT ISSUED - - - y - - - DATE , - - ------------------------------ BUILDING COMMENTS - - - - - "r /} �-�-- ek-t - - - - ---------- ADDITIONAL -------- ------------------------------------------------------------------- -- --------------------------------------------- 1�Y - -- - - --------------- ----- _ - -------------- ---------- - ------ - - - -- ----- -- ----- ------ -------------.Date -- --/- -- � --- ----- Final Inspection by: - - - - -- -------------- - - - ------ --- ----- ----- l ------ SAN J AQU LOCAL HEALTH DISTRICT E. H. 9 1-'68 Rev. 5M