6440 - Laserfiche WebLink

Home Browse Search

Permit No. APPLICATION FOR SANITATION PERMIT / n Date Issued ..%/ 7A - (Complete in Duplicate] . R al Health District for a permit to construct and install the work herein described. Applica}ion is hereby made to the San Joaquin Loc This application is made in compliance with County Ordinance No. 5 . 6� JOB DDRESS AND LOCATION.___ ___ __.__ .- f ------ --------------------- - --------- -- Phone--------------- -------------------- 0 Owner's Name---416 _ ._. l.ZO----------- , -------------••--•----------- ------------------------------- AcldrJis-_------------ ---•------- I� --- ------------•--- Phone- Q 7 -._.__ ---- - -------------- ---- - Contractor's Name-----__. __._ _ � Trailer Court ❑ Motel ❑ Other ❑ �h p Commercial ❑Installation will serve: Residence Apartment 3-louse ❑ ---�- Number of living units- /-.---- Number of bedrooms --- Number of baths _ -- -- Lot size --------7j x 1�---------------- ! Public system Q� Community system ❑ Private ❑ Depth to Water Table -------- ft. Water Supply: Y ClayLoam Clay El Adobe 14 Hardpan [3I Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam F1 Previous Application Made: Yes ❑ No [9, New Construction: Yes [I No [7� 1I TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) __ Material_______________________________ -------------•---- Septic Tank: 1D' tante from nearest well-----------------Distance from foundatiLn_uid de th--------------------------Capacity_.____._____.-________- Iof compartments_ Size-------------------------------- Distance ------------------ --- G p Dispose Field: istance from nearest well_----- _�ength ofeachI line foundation - ....Distancethofttre chest-lot--ine.------_.-----•- u er of lines--------------- 7 pe er filter material-------------------- ---Depth of filter material-----------------------Total length---_-------------- f \ 5ee� age Pit: Distance to nearest well-__I(10.11� ._Distance from foundation____ a__.--.-- ia e topes+est lord# lii- �---- p Gtl �-uSize: Diameter-__- __ .. --- - p Number of pits...�..�-------�--Lining material__ _�� - Distance from nearest well-----------------Distance from foundation--___-__---_____--.Lining material----------..-.--------- els. Cesspool: .-Liquid------.. Capacity_-_.•------- g Size: Diameter-- '------------- ------- -----------Depth--------- --- Distance from nearest Well------- from nearest building----------------------------------------- 1� Privy: ------------------------------------- ❑ ------------- ------- Distance to nearest of ine_____________________ Remodeling and/or repairing describe}:_. -------------------------------- ------ I ---------------------- ---- 11 -- --- ------- ------------ ------ ----------------•---------- -----------•--------------------------------------------------- -- cor with Sa ----aqu I hereby certify that I have prepared thisapplication the San Joaquin Local Heae work llth Dis+r be-done accordance with San Joaquin County ordinances. State laws, andet aregulationse �p 4` ----t{$�wner and/or Contractor] Igned) C ... 5t � ° c /� --------------------------------------(Title) -� . (Plo+ plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side]. �I FOR DEPARTMENT U_SE ONLY DATE ----- APPLICATION ACCEPTED BY_ ---------------•--- ----•---------•---- _�_..---------------------- -------- ----------- R VIEWED BY _ ... DATE gQ/ --------- BUILDING PERMIT ISSUED---------------------------------------- Altera+ions and/or recommendations:- --------- ----------- _____----------_-------- ------------------------ - IM. •------------------------ •----•------------ ------------------ ---� ----- ----- -- -------------------------------------------- ----------------------- Date---- --- ---------- �� FINAL INSPECTION BY:___._- -. _ _.,------- ------ 'SAN JOAQUIN LOCAL HEALTH DISTRICT 132 Sycamore Street 814 North "C" Street 130 South Americany Street 300 West Oak Street Tracy, California Stockton, California Lodi, California Manteca, California 4 i E5-9�2M 1a54a6 ATW000