SU0003905 - Laserfiche WebLink

Home Browse Search

.APPLICATION FOR SANITATION L � ` PE(AIT Permit Na22- ... . .. �........... ............'• �. . ICampleteln Triplicate) ...................... •� pate issue d?..............1 I� This Permit Expires 1 Year From Date Issued i } ��W( tion Is hereby made to the San in com ('once wiHh lthDi trio fo n a permit. and exlusttand i Q Rulestall the nd Regula lana�ein ribed. This application ism mp {1 ....X1.47 .. ,SOB ADDRESS/LOCATION ......,� .. ...PhOO ,. Owner's Name ..... . !Y1 ...t....... ... ........... : �N �.1 ,/ �- �....City Address ..... � . -• ... p E: 'cense # •l' Phone Contractor's Name .. *` , 'L Installationwill serves Residence Apartment House[] Commercial OTraller Court 0 �. �I Motel ❑Other ................................I........... .r- ' � ms Garbage Grinder tot size ,. ... _ Number of living units:---/.... Number of beSkpo ; .• 'I . fU ---..........................................Private Water Supply: Public System and name ..._. f -.. . "- Character of soil to a depth of 3 feet: Sand 0 Slit❑ ' Clay ❑ Peat Q Sandy Loam 0 day Loam ❑ I' Hardpa Adobe❑ Fill Material ............If yes,type............... ••-••••••••- I (Piot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed an reverse stde.y NEW INSTALLATION: (No septic tank or seepage pit,permitted i gyblic sewer Is available within 204 feet,( SEPTIC TANK I I /S�S e ............................................. Liquid Depth ....:.................. . . +� PACKAGE TREATMENT [ I /� I € Capacity ........I........... Type .................... Material...................... No. Compartments ..................... Q ...Foundation ...................... Prop. Line ...................... p Distance to nearest: Well --•••---•-••-•••_-••--- ,i ��.. .............. .�.. Length of ch line.... ..��.......:..... Total length I LEACHING LINE No. of Lines ......./......... 9y.' � JJCC.S� Ip 'D' Box Type Filter Material ...Depth Filter Material ./7•••--••••••-• - -r •--••- . . f- Property Line .i .. foundation ..�................ ...�................. Distance to nearest: Well ..��•••---•••--• • t .L. r V Depth `�........... Diameter . -. Number r...................... . Rock Filled Yes No ❑4 SEEPAGE PIT p •-••- --.... � } Water Table Depth ..._...��•�, -. .......................... Siza d............................Fou n .fiG!'.......... Prop. line . ............... �:�► Foundation - Diatance to nearest: Welk. �Cl.. REPAIR/ADDITION(Prov. Sanitation Permit# .71�7J PRY . ,�s• 7�;. Date .........-•••...........•....... 1 . I Requirements) .............. .�0�-S3 Y....: .. .. ............ Septic Tank �Spodfy q ....�?G� errd�•• .�. .-. � .. F .p i Requirements) ..� ..... ...:(�... �C .... ... .............. .a Disposal Field (Specify q .............. �M ........................................... ., .. . ...... .. ....... . .. ......................._.................. .-............................._..I........_....... (Draw existing and required addition on reverse side) 1 hereby c rtify that I have prepared this application and that the work will be done In accordance with SitR Joaquin County Ordinance:, State Laws, and Rules and Reguialians of the San Joaquin Local Health District. Home owner or Ilcen- F sed agentssignature certifies the following: "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." CLARENCE'S SEPTIC & SEWER SERVICE IM .... Owner 263 So. fro �, Stockton, Calif. 95205' Signed .. .. .. .......................... ..... ...._......_......_. Plt.463.-3209 Contractor's tic. #2o1.. B -- ... Title ..................:.. .... .. ............. .. .•-............_............. By �� (If other than own FPR D MEN USE O LY '. 7... APPLICATION ACCEPTED 6 - _..:.... DATE ....].`.�..... .............�.:: ... .... _._ DATE . BUILDING PERMIT ISSUED .. .......... ................_....... : ADDITIONAL COMMENTS ............................... ............................................... ......................................... .................................................. I6 .......................................................... .. .. ..........................................................•................ .r. 41 ..1.. ...........,..... Date .. Final Inspection by: L� Ell 13 2i 1-68 Rev. 94 SA 10AQUIN LOCAL HEALTH DISTRICT 8/7h 3M I ,