75-151 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT )a Permit No: ...�s !S1 l � r----------------- ---- (Complete in Triplicate) Date Issued ...................................................... .......�_ 7S 3._:.... ........ This Permit Expires 1 Year From Date Issued � �-3 z��- 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 existing Rules and Regulations. ' N/E Coiner of Farm and Gertrude- ............ JOB ADDRESS/LOCATION ................... .. ... ...--......................................................CENSl.o TRACT ............. Owner's Name :Timmie Winchell .......................................S.tocktohrone ..-.... 3a_'5�..E... .Main City Address ......... ...............:.............. ................................................••.....•---------•--.....-----..... .._ Contractor's Name ........Ro-to..1�.o.o.ter...S.er-_----- _-- .........•..........License*# ..2.71,539....... Phone �b5-•2bl ........ . Installation will serve: . Residence ® Apartment House] Commercial ❑Trailer Court 0 Number of livingunits:............ Numberofb❑edr oms ..3... ...Garbage Grinder ..ye5--- Lot Size 55---�--1�?�----------- ••-•••--• - Calif. Water Ser. Private Q Water Supply: Public System and name ............:••••- _.. ------................................. ...................... . Character of soil to a depth of 3 feet: Sand❑ .Silt❑ Clay ❑ ' Peat❑ Sandy Loam.❑ Clay Loom ❑ (� Hardpan © Adobe IM Fill Material ...fig....• If yes,type ------_---_-------------- (Plot plan, showing size of lot, location of. system in relation ta-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 '"' "Size....-.J r•-.. t__-- I............ Liquid Depth _kgR4x---L�4t- Capacity 12-0.0.......... Type Pre--•Qa3•tMaterial----------- Compartments ..F.................. n/a f r r Distance to nearest: Well ............._------._.•-...•----•Foundation ...1�.........--.._ Prop. Lines...-•._........:.._. a LEACHING LINE No. of Lines .... -- length of each line....&5-.8c-•&�-�-•-- Total length 17-Q! .- 'D' Box ..ye.S._-'Type Filter Material .rg gjR....---•Depth Filter Material ---------_---------- - - ---• Line ....f................:.7 i ' Distance to nearest: Well .-_--n/e-----_..._ Foundation ..��............ .... Property SEEPAGE PIT [ Depth - 5't.. . ....6.... Diameter 3�tt........ Number ....2............ ...... Rock iFilled Yes ® No ❑ I Water Table Depth _ - t.... :....... Rock Size ....Z ....by .... C --• i n/s + r Distance to nearest: Well ...Foundation 1�............... Prop. Line ..__._.___..-:..___-.• F REPAIR/ADDITION(Prev. Sanitation Permit#6E -----• Date .................................. Septic Tank (Specify Requirements) ---------------------------- --•---..........------••---------•---•--•-----........ ........................ ....-----••--.................. Disposal Field (Specify Requirements) ................ ---------------------------•-•-------------- --------......................................--------- .... ...................•---••-------....-...-._..-----.....-------------•-••-------------------T•--•------------•------------.....-----------•---•-----------...-....-------•---.-._...--------------------- .---...._.......-•............. ......................................................••-•-----------••-•-------..........---------•--•-----------...---------.-------------------------- I (Draw 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 Sarr Joaquin Local Health District. Home owner ar titan- sed agents signature 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 became subject to Workman's Compensation laws of California." Signed ................................... ----• --..... _•----- --- Contractor -- Owner -- Title --------------•-•--..............-................. (If er than owner) R DEAR MEN'S USE ONLY APPLICATION ACCEPTED BY .. .. ................ DATE BUILDING PERMIT ISSUED .DATE ( ADDITIONAL COMMENTS .........................................................•------..............I............-----..---- ..._..----............................... .....-•....... ......------......--•-..--•---• ----------------- -� ....------. -_------ ! .. 5 . ....... ------------------------ t'......�.....--- ...... rf--------• . ...........•• Date --- ----------- l..... Final Inspection by: �. ....Date JOAQUIN LOCAL HEALTH DISTRICT 7/72 3 M