SU0001042 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: iPermit No. T��• ._._.. APPLICATION FOR SANITATION P (Complete in Duplicate) Date Issuedl.__.-.3-' � This Permit Expires 1 Year From Date Issue P.;:pIication is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. Tnis application is made in compliance with County Ordinance No. 549. x._. JOB ADDRESS A LO ATION.:— ,._ _. . � .-`-... Phone---•--•---------------------------- Cwner s Name.----—�Wed---- ------ . � ------------------------------------------------------- ----- , �--Address � \ +� one._. . -y ' � ----------------••----------- Ph Contractor's Name_ . -} -�- •- �- Installation will serve: Residence �Kpartment House ❑ Commercial ❑ Trailer Court ❑ Motel [I Other ❑ Number of living units: __ ._. Number of bedrooms-l.._._ Number of the --____ Lot size _. _ '' '' u I : Publics stem ❑ Community system ❑ Private Depth to Water Ta�� Water S pp y YAdobe Character of soil to a depth of 3 feet: Sand ❑ Cravel ❑ Sandy Loam ❑ Clay Loam HA/VA: Y❑es ❑ rdplvaon a Previous Application Made: (If yes,dote. . .-) No ❑ New Construction: Yes [IN TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) el, L 'ii i Material �f •------------- T Y ---- Septic Tank: Distance from nearesT wel ..� Distance tro toun anon_ hh -- 'e �igwd depth--- . Capacity----------------- No. ----- - No. of compartments-""Y______________.Size, -{� "" 7` G-----•- i Distance from foundation. -----•Distance to nearest lot line..,.. os el Distance from nearest well.`............. Width of trench.._ ' °`--•---•----- Number of Ii ____Length of each line_LQ- -�--- Type of filter materia --.--Depth of filter material_.____ ._.------Total length___________________ ------"-- �' 1 Seepage Pit: Distance-to nearest well__.____"_____________"Distance from foundation--------------------Distance to nearest lot ine_____.__._.____ - - - ❑ Number of pits---------------------Lining material-__.____._.--------- Size: Diameter._.___....._.---_-.- Depth.......---------------_________Distance from foundation.._._._____.__.___..Lining material---._-__...._..__.....__.------'a Cesspool: Distance from nearest well________ ls. ❑ Size: Diameter................................. ----De th----------------------------------------------------Liquid Capacity----------------------- 9 y: Distance from nearest well_".-___ -��•�•---_-----. _----_--•-_---------Distance from nearest building ------ Priv --•----------------------------------------------------•-------------------------------- ❑ Distance to nearest lot line_________________________________________________ -- ----------- - Remodeling and/or repairing (describe):__--- •--• �� ---- ----- -;aie, --------- ' > .. ___ ---------------- -------- -- - - �-n- -------------------------------------•----------------------------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State lawsx?,nd rules and regulations of the San Aaquin Local Health District. -Aw -------------------------------- --- - -------(Owner and/or Contractor) (Signed)---------- .-- --------•----------------------- -- SEPTIC TANK SERVICE --------------------------------- --- - Lt --------- -------------(Title)-••--------------- ------------------ .. ----------- - BYS32fi f:tvttrreY AOe Hp o 4i" (Plot plan, showing size of lot, location of system in relation o wells, buildings, etc., can be placed on reverse side). FOR DE ARTMENT USE ONLY APPLICATION ACCEPTED BY.. -'--7--- -- -- - DATE l '-3- REVIEWEDBy------------------------------------------ ................................................ BUILDING PERMIT ISSUED---------------------_............._........................ ----•--------------•-------"------------•---•------••------•------•- Alterations and/or recommendations...........................-........................................... .......................................w------_--_---_----_. ------------------------------- ; ------------- -•-------•------•--.............. FINAL INSPECTION B ------- --- ---- Date-----/-+Z ..q ---•-- -------------- ...... SAN JOAQUIN LOCAL HEALTH DISTRICT l 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street ` Lodi, California Manteca, California Tracy, California Stockton, California