SU0006090 SSNL - Laserfiche WebLink

Home Browse Search

hUK U"K-t USt: 6. 4fLICATION FOR SANITATION Pr ,-a6 Permit No. .laf:/—,6-. - ..- ------------- - ---------------- ------- (Complete-in Duplicate) 7 Date Issued This Permit Expires 1 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 witl1&u8Ve3difajl6Aab 16911rbor LJOB ADDRESS AND LOCATION_.____.____3401 So. Whiskey Slough Road, Holtz California...... _- Owner's Name... E<A..VA----H0.>?XQ-rt .s.._r ZQ.................................................................. ...... Phone------------------------ -------- Address._._..........._3401 So. Whiskey Slough Road, Holt, California ---- .................-- ••-..._..-------- r Contractor's Name---'-`----Q!�A!er----------------------------------------- ------------------------ Phone...------------------—......... Installation will serve: Residence ❑ Apartment House ❑ Commercial M Trail Court Motel ❑ ther ❑ Number of living units: _. ----- Number of bedrooms ........ Number of ba s .. a ... ... ........ _. ------------......... ...... Water Supply: Public system ❑ Community system E] Private E) Dept to Wa able .. _ . ft Character of soil to a depth of 3 feet- Sand E] Gravel E] Sandy Loam Clay Loam lay dobe ❑ Hardpan ❑ Previous Application Made: (If yes,date................... ) No ❑ New fly ru ion: Yes ❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: ��►/✓ C,*V,Mi.v-COMP 0`.7Ctc?,$-" eF ti t or cess ool ermitfed if ublic wer is av d 61a within 200 feet. eff )?f /+M;;� !j/T P P P / Ar%,-A 4ft�y�T;74) r 7T Distance from nearest weIL - -a._.- .Di nce from fgundation._ ..... ._/Mat�r�aliPClMe.JE'i.P� -?Mf_.t P-Ati/f-/�6/. No, of compartments......__-�_------- S ..._X.x.�. uid depth../a0,. .----_ ----...-Capacity_lsbo j.,! y ge) r h/ /• o d . 1 / O Disposal i -.---. ..-- -------..... e"'--------'-- rol 694lali'6M �.....\ i- _t �. _ Y� ry Lwaa_....---------------- .r.aTn-r�.--4z......------------------------------- 0 fov /1 I-- ------ ----....Depth of fi material--`-------------`-`-T r"4h---------------------`------'----- Seepage Pit. Distance to ear t __--Distan foundation....................Distance to nearest lot line..._...._.__._. to. ❑ Number of s ._____..____._-Lin ng mat a -..__.- Size: Diameter-----------------------Depth_____.._...._-_---__.-.___._- Cesspool: Distance fro n well ... .....-- once fro tion................. ..Lining material-.---------_.._._--_.._._.--_--. ❑ Size: Diame+e -- ---_..------ ---- - fh----._.......---------------------------------Liquid Cepaci+y..-------------------gals. r, Privy: Distance from nearest well...:... .....................................Distance from nearest building-----------____-__-_-..-------._.__._- ❑ Distance to nearest lot line----- _..............-..._.._._-__...—`_______._______--_.._...__-_..__-..___.-_--_..--.._._...._.._----------------- CAURCtt � )e LeLfeR �2IIWA .AA .v1.E..vlrc.9ivFr"erdErr C./Yo st�jewrco. Remodeling all/or rep�/mng/}a cubeQ:..._._..._...._._._.__._._.__...________._. _�9.�.TPd _1-Uye,I'R_.. _o�tgLe_ . . T/ / f G /f]IR 5�' trv-rzkk_r.Edapplica+fon and that +he work will be done in accofdance Iii#h San Joaquin Counityy' ordinances, Stafe lIrs, and rules and r gu tions of the San J aquin Local Health District. (Signed).----- -- .i..( _,.-- - - -------- ----------- ---------------(Owner and/or Contractor) ` By:...... ------------------------------------------------------------ ..--------------------- ....... -- ----(Title)---------._.----------------------------.._...- - (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). see PR DEP TMENT USE ONLY APPLICATION ACCEPTED BY_. .. ..........- --- _ __._.. ..._... F�+M.____. DATE.... ._ -_ 71-(0-4 --------------------------- -- --------------------- REVIEWEDBY............................................... ..........------------- .................. DATE.•-- ---- -----I------- --.............. BUILDINGPERMIT ISSUED....... ----------....-..............................--..................................... DATE--------------------------------------------------- Al+era+ions and/or recommendations:............................ --................... ---•........---....................................... - -------------------------------------------------------------------------------------------------------------- -------......---------.............-----------------------------— _ 1 - .................-------- ----- --- ----------------- - ---------------------•-- --------------------------------------- - -- -- --. --------- -------------.__----------- .............. -----------------------......------................. ...................-------- a. jigV FINA IN PECTIO Y:.... .__ __.... -... o .. QQ 54h1 JOAQU HEALTH DISTRICT 1601 E.Hassllon Ave. 300 West Oak Street 124 Sycam.rs street 205 West 9th Street Stockton,California Lodi. California Manteca,California Tracy,California E.H.9 2M 1.67 Vanguard Press