Laserfiche WebLink
APPLICATION FOR SANITATION PERMIT Permit No. <br /> (Complete Uup|��t� <br /> ' Date Issued <br /> heApplication is <br /> reby made mo6e to the San Joaquin Local Health District for a permit +oconstruct and install the work herein described. <br /> This application is mo6o in compliance with County Ordinance No. 549. <br /> -------------------------------------- <br /> OF <br /> Installation will sone: Residence [4 Apartment HouseCommoncio| 0Trui|e, Court [] Motel [� Other [] <br /> Number of living units: -A---- Number of.6e6moms -^�— Number of baths .\—' Lot size ................................... <br /> Water Supply: Public system [] Community system F] Private M Depth to Water Table ft <br /> Character of ,vU to u depth of {oat Sand [] Gravel [] Sandy Loom F-1 Clay Loam 2 Clay El Adobe [l Hardpan [] <br /> Previous Application Made: Yes E] No [2 New Construction: Yeo [:] No M FHA/VA. Yes E] No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (Nn septic po,nnif+e6 if pu6|ic ,e*er i, avai|m6|ewithin 200 feet.) <br /> Septic Tunk: a f,om nourostwaU—_----Distonce from foun6ution—'-------��ote,iaL-------.-----_'----_ <br /> Ll ' mo./f compartments--------------------------Size--------------------------------Liquid clop+h--------------------------Capacity..............-------- <br /> Disposal <br /> _-..Dispox | Ho|6: Distance from 1�� Distance from fou d6 '?w" Distance to nearest lot |i e.J~' <br /> -- � Length— each line' ' _ '_� <br /> Type of filter <br /> Seepage Pit: Distance <br /> �0 to nearest well---I. --------Distance from fo,�nclation__2A------------Distance to near 6st lot line---- <br /> Number /--------------Lining mufariu| _Size: Diomotec-.�U---. �O <br /> Cesspool: Distance from nearest well --_--'Distance from foundation--------------------Lining material--------------------------Size: Diamotoc_— - De ----------------------------------------------------Liquid Capacity—_.---_—.--gals. <br /> ------------------------------------ <br /> --------------------------------------------------------------------------------------------- I-------------- r-7 -------------/ ---------------------------------------------------------- <br /> --------------------------------- <br /> I here6y certify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> ---------._--------(Owner-and/or Contractor) <br /> ' ------- --------------------------_--_--_---.--_--_._--'—_-----`--,—____-----_-----.--- <br /> (Plot plan, showing size of lot, location of system in relation to wells. 6ui|6ings, ofc. can 6e placed on ,ovone side). � <br /> FOR DEPARTMENT USE ONLY <br /> BU|LD|NG PERMIT ISSUED------------------------------------------------------------- -------------------------------------- DATE------- <br /> -.--______-_-_________ ' <br /> A�e,u�mnsand/or ,ocnmmenJat�n,'---_—'—__—.__-- ----_—__--_'__ ___ <br /> --------------------------'---'---------------'-'--'-'-------------'—'-----'-'------'-------' <br /> -----------------------------------------------------.................................................... ---------'----------------'---'------ <br /> '—'------'----'--------'--------'----------'---'------'-----'---------'-----------------'-------'—'-------' <br /> --------------'--'----------'--''---'----'---------------------'----'-------'------------ <br /> FINAL INSPECTION BY Date. -------^—.____. ' <br /> ° SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> /»o South American Street 300 West Oak Street 132 Sycamore Street V/+ North ^cr' Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br />