Laserfiche WebLink
FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT / <br /> Permit No. .7v_ V <br /> (Complete in Triplicate) <br /> : <br /> ----..... .. .......--- ....................... ......... - <br /> _....:.�_•--�� <br /> This Permit 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 /> JOS ADDRESS/LOCATION ..�92D1T,orraine Ave. acY: Ga}.i 'oiia"�`"' CENSUS TRACT --------------------- <br /> --- <br /> Owner;s Name Joe Esp na2a *, +_ ............Phone <br /> .....D35--05L9 <br /> «wt. Y. .. v-.- % ail: <br /> i <br /> California <br /> - S . ...... ............Address 920o -•1BnVLteeV ity --••---_-- <br /> • <br /> - _ l��l ---. Phone _ 4bbgb4 -•-•----.. <br /> Contractor's Name ------------------D.A••..P.arrsh..&.Sons.....ITAC.---- _----_-License # __-_-- <br /> Installation will serve: Residence$$(AAartmtt House[] Commercial ❑Trailer Court <br /> . .. ,......_Motel.Q,Cither_ � �---- --------- <br /> Number of living.-units:...Z------ Number of,bedrooms ....4......Garbo$ Grinder ___.;G?O-.. Lof.Size _75-X_200-------------- <br /> Water Supply: Pub4c-System and nam"e� _d k ',­--------------_---- ------------•- :.._... Private g] <br /> Character of soil to a depth of 3 feet: (Sand❑ Silt[M Clay C] peat F-1Sandy Loam ❑ Clay Loam 0 <br /> ��"+Hardpan[] Adobe-r-j" Fill Material ------_. 1I yes,type <br /> (Plot plan, showing size of lot7location of system intrelation Ta.,wells, uddings, tc. must be placed on reverse side.) ,A <br /> NEW INSTALLATION:, (No septic tank or seepage pit permitted if public sewer is available within 240 feet,) <br /> i t � �-- Liquid Depth ---__521! <br /> TREATMENT �] SEPTIC TANK.[.]' Size.,.. ll q p <br /> -- ----- <br /> it C._ tY g Types,Pr�.aat_.. Material__. DOIID & No. Compartments •----_--2..----..•... <br /> y <br /> �,., apaci�l.�QQ• � � <br /> s --� t —� Foundation _101 . _ Prop. Line ...��............... <br /> Distance to neares We(I ._ 64................... . V-:---- <br /> LEACHING LINE No. of 'Lines '... ............__.-. � gth of eac}i'line_.t�0�-t _�A�,..�:�Qotal Length .._��r_ <br /> Len t I r^r ---•--••-•------ <br /> D' Box._.1-... Type Filter Material .A..n..........Depth FilteI <br /> Material M...•--•.•__---•------------•••--------- <br /> i � , ©�. .. ! roperty Line -5-.................... <br /> i Distance to,nearest-' Well ..... ....._ Fovndotion l5_ ..-.--- -- <br /> SEEPAGE PIT . [ ) Depth :... _.... Diameter --------------- Number -----. fll----------- Rock Filled Yes (3 No Q <br /> �.....it <br /> Water able Depth ..........� 1.--------------------------------Rock Size 1 n 2 --_-------- <br /> Distance to nearest: Well ._.._._.1QQ!_- _._.....__Foundation _..1Q�......_... Prop. Line ... ................ <br /> K Date I_.._. <br /> REPAIRIADDITION(Prey. Sanitation Permit# ..-._-------_._....--_- ) <br /> Septic Tank (Specify Requirements) __.......................................... .... -- --•-••-•--•--•_•-.-.._., _._....._----------------- <br /> iDisposal Field; (Specify Requirements) ................................................... <br /> . J <br /> .................... .................................................. <br /> ............................._..._..........--_-_.-..-----•-•--.------...-_._._••__--••-•----_..._.-.....- ._-___....._..;-.-..--..--. <br /> . . <br /> - !- I....... .. ....... ........ <br /> #) (Draw existing and required addition on reverse side) <br /> I I hereby certify that I have prepared this application and,that the work will be done in accordance with San Joaquin <br /> County Ordinances, State Laws, and Rules and Regulations of.the.Son Joaquin Local Heal District. Home owner or licen- <br /> sed agents signofure certifies the following: <br /> "I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in such manner <br /> as to become subject to Workman's Compensation laws of California." <br /> i Signed�((If�ot <br /> D Arah & <br /> Title ----- ------------ <br /> By. <br /> wner) <br /> FOR DEPAitTMENT U E ONLY <br /> ---------------------- <br /> APPLICATION ACCEPTED BY ......... ---....._-. DATE .1. a- d <br /> BUILDING PERMIT ISSUED • ... ......... .. . DATE ......... <br /> •-- <br /> ADDITIONAL COMMENTS ----••-........................................... ----•--•--------........_..-_-. <br /> --------------- ------------------ • -- - <br /> ----------------------------•- <br /> t............. '----•---••-- <br /> ----------•- ........`:............. . . . ............ <br /> ........................................................• ...............--- <br /> ----- - --- --. .. = <br /> Final Inspection by, ..._....-•-- --- �'!!"--...Date ^ ._L2-�7 J.... .. . ...... , <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> E. H. 9 1-'68 Rev. 5M <br />