My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SU0003930 SSNL
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
W
>
WEST RIPON
>
9534
>
2600 - Land Use Program
>
PA-0200345
>
SU0003930 SSNL
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
12/5/2019 4:58:47 PM
Creation date
12/5/2019 4:42:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0003930
PE
2622
FACILITY_NAME
PA-0200345
STREET_NUMBER
9534
Direction
E
STREET_NAME
WEST RIPON
STREET_TYPE
RD
City
MANTECA
ENTERED_DATE
5/11/2004 12:00:00 AM
SITE_LOCATION
9534 E WEST RIPON RD
RECEIVED_DATE
8/13/2002 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\gmartinez
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
46
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
PPLICATION FOR SANITATION PEr 'T <br /> L i.• Permit No. <br /> (Complete in.Triplicate) ^ <br /> ........................... This Permlt Expires 1 Year From Date Issued Date issued <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein <br /> described. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: <br /> JOB ADDRESS/LOCA ON .._.. ...[...5.. .T...._ <br /> •---..��......_ ......................CENSUS TRACT .......................... <br /> Owner's NaCme ..... _ /.- .......... ................••••-••--............ <br /> ..................Phone ......................... <br /> Address ........z ----••----- <br /> :; � ...............City . <br /> Contractor's Name _.- ' T G _ _ /(�'!�j( .. license # .o�� _. Phone -----------------------_----- <br /> Installation will serve: Residence Pq Apartment House Commercial❑Trailer Court ❑ <br /> Motel ❑Other............................................ <br /> Number of living units:.... Number of bedrooms ....q....Garbage Grinder Lot Size 1� -- <br /> .... ._...__ ------- -• .... .... ................. <br /> Water Supply: Public System and name .......................................................... ------------------------------------------Private <br /> Character of soil to a depth of 3 feet: Sand W Silt❑ Clay ❑ Peat❑ Sandy Loam ❑ Clay Loam ❑ <br /> Hardpan[] Adobe 0 Fill Material ............ If yes,type............... ............ <br /> (Plot plan, showing size of lot, location of system in relation to wel(s,'buildings, etc. must be placed on reverse side.) <br /> NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) <br /> PACKAGE TREATMENT [ ] SEPTIC TANK ] Size. l..L. �.', z� .............. Liquid Uquid Depth .. .................... <br /> ...,.. <br /> Capacity ZkQ0 Type ,(l .f t! M` jjaterial.�'?!t- ^ ... .No. Compartments <br /> Distance to nearest: Well ...../0_Q. Foundation ../01........ Prop. Line _____ .............. <br /> ---_ Length of each line..._.2d <br /> LEACHING LINE No. of Lines ..... <br /> [ J `J�...__...._ _ Total Length <br /> ............. <br /> 'D' Box .... ..__. Type Filter Material .1i......... ..Depth Filter Material /�` ..�_� ........... <br /> Distance to nearest: Well ..../Q.�?.._ Foundation .....%0. .......... Property Line 5.............. <br /> SEEPAGE PIT [ j Depth ...................... Diameter ................ .Number ............................ Rock Filled Yes ❑ No ❑ <br /> Water Table Depth ...___.__._••-•.................................Rock Size ................................ <br /> Distance to nearest: Well ........................................Foundation .................... Prop. line ...................... <br /> REPAIR/ADDITION(Prev. Sanitation Permit# ............................................ Date .................................. <br /> SepticTank (Specify Requirements) -•-----•--•-........--••-•......................................••-•-•---.........._.._..._..--•-•-..........--•-------------•------..__.... <br /> Dispbsa) Field (Specify Requirements) ----•-----•-•----...----•--•--•..........................................•--• <br /> ............-- --------------------------------- <br /> ........._..a i..................................................................... ..... <br /> (Draw existing and required addition on reverse side) <br /> I hereby certify that I have prepared this application and that the work will be done In accordance with Son Joaquin <br /> County;Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local Health-District. Home owner or Rin- <br /> sed agents signature certifies the following: <br /> "I certify thatlss-sloe performanc of worms hich this permit Is issued, I shall not employ any person in such manner <br /> as to be <br /> esu t to Wor C s 1� gf California." <br /> Signed . <br /> ---- ----- - -- . Owner .. <br /> By ................................. -------•-------------------••--------•••--...---•-----•.............. Title ..---.................. <br /> (If other than owner) <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY ...... . .. .. ...... ..••.... <br /> ... -•--.....,. .: :.. ................. DATE ......5..-.3 <br /> BUILDING PERMIT ISSUED ....... ................. ------- <br /> .. - <br /> DATE . ......................................... <br /> ....... <br /> ADDITIONAL COMMENTS .._... :_.... _.... <br /> ................................................................................................................................................•. <br /> --• ---...-•...................•-.........................................._........•-•............................................... ....... <br /> ......................... ... <br /> Final Inspection by: ........... <br /> ............. ..................................................................................... . -- ... <br /> ..... .R.._....Date ... .. ..� •- <br /> .. . .. ... ........................................ .... . .. .. �' 1:.. <br /> EH 13 2!, 1-68 )Lev. .. <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT 8/7h X4 <br /> 161. ' r - <br />
The URL can be used to link to this page
Your browser does not support the video tag.