Laserfiche WebLink
FO', QFFICE USE <br /> �+,.. .�.�.1.7..7..... <br /> APPLICATION• FL 4% SANITATION PERMIT Permit No. <br /> (Complete in D.-rikate) Date Issued <br /> _ _.. .. .. This permit Expires-1 Year From Date Issued <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work heroin descrbed. <br /> This application is made in compliance with County Ordinance No. 544. <br /> ege) <br /> ................ <br /> .IOB ADDRESS AND LOCATION................................ <br /> Owner's Name......... ... .................... ...................... . ............................... . Phone.. ........- ..... <br /> .............. <br /> d -r.................... ................................................ .................. <br /> Address.......................S.C......<.��....,.... .._. ..................................._. <br /> .....- Phone.................................. <br /> Contractor's Name.... <br /> Installation will serve: Residence (D'Apartment House ❑ Commercial ❑ Trailer Cott ❑ Motel ❑ Other ❑ <br /> Number of living units: Z.... Number of bedrooms .-5�. Number of baths :_". Lot size ........ ......1" <br /> Water Supply: Public system ❑ Community syst.lm ❑ Private Er-bepth :o Water Table c. ft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy '_oam❑ Clay Loam a--Clay❑ Adobe❑ Hardpan [" <br /> Previous Application Made: (If yes,date_.... _. _. . . ) No [- New Construction: Yes ❑ No Q' FHA/VA: Yes❑ No❑ (� <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: C' <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> SeptiTagk: �,eDistance from nearest well.... .......Dirtance from foundation..._..............Materiel....................................... .... <br /> 4jCJs" /�do. of compartments......... .... tae...................._.........._Lrquid depth.......... .. . ---_-- C,apacity....................... <br /> Disposal a!d: J Distance from nearest well. � .Distance from foundation....l...� .....Distance to nearest lot lipe......:r.... ' <br /> 7 Number of lines................,.. . Length of each line...........,t'-J?.•..• .•.Width of trench........? .-1....q.---.-•- ' <br /> Type of filter material.... ...... :f...Do +h of fifer material..... ... .'o'.nl length...........T'-L........ ' <br /> Seepage Pit: �j Distance to nearest well..47T........Distance from foundation.............Distance to nearest lot lino.............. <br /> Number of pi Lining meterie!r- ........-. meter . ._.. ep h-/...1-..—............. <br /> Cesspool: Distance from nearest well............. ...Distance from foundation. ...........-.. Lining material............................... .... <br /> ❑ Size: Diameter.............. ... . .. ... .......Depth............... ................................Liquid Capacity...........................gals. <br /> Privy: Distance from nearest well. ...................... .Distance from nearest building......................................... <br /> ❑ Distance to nearest lot lin3.................... ............................._............--•--............_....................... <br /> Remodeling and/or repairing (describe): ......... ................................................................................_.........._........... <br /> ..............................................................................................................._..................................... <br /> .............................................................................................................................. <br /> . ............................... ......................................................•--......................_........._...................._............._....................................................... <br /> 1 hereby certify A I have prepared this, pplication and that the work will be done in accordance with San Joaquin County <br /> ordinance St �11aw"sanddules end regulati f the San Joaquin Loul Health District. <br /> I�f ............ ...................... ...............................I—..........(Owner and/or Contractor) <br /> (Signed„ ................................ .... .... <br /> BY:...................................................................................... ....................... ...._........... .(Tifle)........................................ .. <br /> (Plot plan.showing sae of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). _ <br /> FOR DEPARTMENT USE ONLY --�-- <br /> b L J— <br /> APPLICATION ACCEPTED BY.......... .:.Z .. .. .... . .....�.���..................................... DATE..... <br /> ....... ....r��............... <br /> REVIEWED By................................. ............................................... DATE............................................................ <br /> ............................... ............ . <br /> BUILDING PERMIT ISSUED............................... _................... <br /> ......... <br /> .......... <br /> DATE. ..................... <br /> .. .�.................. -... <br /> Afteratiorts and/or recommendations.........'! �.. ..................T.. ......�. � ..�.`--� c. <br /> �....� <br /> s.Icr..�7e� :-F........r.... �C..... 4............ ............. f---- - <br /> ....^�S...r�`—)- -'�.�a` .—/ Y l� �..R <br /> ...... - ..t �.....�ti:.....�Lf .�.::�....... �t......rl�...�......... �....�....�f�..........t.... ... � - <br /> tt-r _ ..........!'• r. r:•::�L:' 's --` _ f ... ...:L... ... <br /> ..... <br /> Aja t..fi... _ ._..... <br /> �..: >"f.-. •:.��t �r.(.....�. -�_ j- t Vii. • ._- �" ( '/ �. L,.c._ /.. a� <br /> -L-a F=4�.c `4,-5-' /.. '7 <br /> ♦r.'�' ` /��/C' 't <br /> FINAL INSPECTIQr� 8'r���`~�'. "►�-.., '-- <br /> ,n-C N J UIN Ah HEALTH DISTRICT- <br /> .t,..a (c I Cr-1�- _ - - i.e.7- C-/�...,. <br /> c� o c"_-t�"�'��. 121 Sycamore Stmt 20!Woof 0th SnNt <br /> -1601 1.Ha6M)Ave. T 3 WMr Oaf „e c y <br /> Stockton,CalMornb fedi,Collfarnb 91 <br /> I Menf",California Tracy,Celifemle <br /> '` '.l r a <br />