22298 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: -------------- --------- ------------- ----- - APPLICATION FOR SANITATION PERMIT Pornit No. . ------- ------------------------------------- (Complete-in Duplicate) - --------- / This Permit Expires 1 Year From Date Issued Date Issued .-- �?- .-- Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described.t This application is made in compliance with County Ordinance N . 549. JOB ADDRESS AND LOCATION----- Nam ------ -- - --- --- ---- Phone--- Owner's 11 Address......._J.(.I-o-6----- - f ------- •----E ---�--------------------- ------------- Contractor's Name---------------C4ftZ-- -------------- --------- ------ Phone__ --------.---- Installation will serve: Residence gal`*A�partment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ._L.. Number of bedrooms .-.)_L'^Number of baths I--- Lot size ....7$ C..RF_A_q_k--------------------------- Water Supply: Public system ❑ Community system ❑ Private Depth to Water Table 16. - ft Character of sail to a depth of 3 feet- Sand Gravel E] Sandy Loam ❑ Clay Loam jy Cl;;��FHA/VA: ❑ Adobe E] Hardpan ©' Previous Application Made: {If yes,dote------ ) No DR/ New Construction: Yes E] No Yes ❑ No TYPE OF INSTALLATION AND SPECIFICATIONS: \(� (No septic tank or cesspool permitted if public-sewer is available-within-200-feet.) - Septic Tank: Distance from nearest well---6-.0---------Distance from foundh ation_ ...............Material .CP1V.-C_Px._E_T-�---------------- LtjT1P{ . of compartments ------2'-----------..Size----- -- -----------Liquid depth--- �� Capacity----------------------- Disposal Field: Distance from nearest well._6. -------..Distance from foundation---I- 1_____________Distance to nearest lot line.',_. .------- Number of lines ----- ----------- Length of each line_ . + ` � �- - -------- 9 --�-/�--�- _O------Width of trench.- �--------- -- ---- Type of filter material. Q.Of........Depth of filter material__ q--_--_--___--_Total length---.t<..j.., ----------.._,_____-------. Seepage Pit: Distance to nearest well...(_Af---------Distance from foundation---L9.0_..----_Distance to nearest lot line.73-.- ^ ©i Number of pits___6--------------_Lining material___d_CX_ Size: Diameter f A..$._...-._.Depth__f_A-._.____---._-.-- Cesspool: Distance from nearest well ----------------Distance from foundation____...._._...... ..Lining material------..___. _----..----- ❑ Size: Diameter- -- --------- ----- -__---------- Depth--------- - --- --------------------------........Liquid Capacity----------------------------gals. Privy: Distance from nearest well..........................._-..._.____._._.._...Distance from nearest building-.-.-...._________-.-----------------. ❑ Distance to nearest lot line ---------------------- ---------- -----------------------------__------------------------------------------------------- - Remodeling and/or repairing (des'riiJe):-- r .--- .�-- J_..--- --- 1,r..Y.r1 -------(-_ ------- ---------- ---------------------------- ---- • --------- ------- -------- 1 -------------•----.----------------------------------------------------- -- -•----- - - r------------------------------------------------------- ---------------------------------------------------------- -- ---------------- -------------- ------------- ------------_ --------------•---------------------------------------------------------------- ------------------------------------------------------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. j (Signed) ' `�'---- -�: -------------------------- --------------- --- --- ---------- -----(Owner and/or Contractor) By:---.------------.----------•-----------•------- ---------------------------------------- --------=------------------:-----------(Title)=--------- -- - - - --------- ---------- -- .......... -- (Piot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). ' FOR DEPARTMENT USE.ONLY APPLICATION ACCEPTED BY-------�T_A.-1 - ------------ ------ ----------------------- DATE------- ` REVIEWEDBY-------------------------------------------- ------------------- ---------- --------- ---- - ------------------------------ DATE------. BUILDING PERMIT ISSUED-------- -- -- ----------- ------------------------------------------------------------------------- DATE------- - Alterations and/or recommendations--------------------------------------------------- --------------------------------------------- ------------•------ ------------------•---------------------- ------------------------------------ ------------------------------------ --------------------------------- ------------------------------- -- - ----------- •--•---------------•-- --------------------------------- ---------- - ----- - --------------- --- ------ ----------------------------------------- ------ ------- ------- .-- ----------- ------ ------------------------------- FINAL INSPE - Date ^ ;--------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Mazolton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street 1 Stockton,California Lodi. California Manteca,California Tracy,California E.H.9 2M 1-67 Vanguard Press r % F