SU0013545 - Laserfiche WebLink

Home Browse Search

r�•�y I VUG�, I�� ) � Ell ,.; 3 s S �~ FOR OFFICE USE: ` �.•Ja APPLICATION FOR SANITATION PERMIT ,- ;Complete in Triplicate) Permit No. 7j'.p�. This Permit Expires 1 Yea-From Date Issued Date Issued Application is hereoy mode to the Son Joaquin Local Health District for a permit to con.truct an-.1 install the work hereir described. This application is made in comoiicnce with County Ord:nonce No. 549 and existing Rules and Regulations: 4k` JG3 ADDRESS/LOCATION 02 2+.. r�9i•bnntCi, r7 CcNSUS TRACT .. _ ...._...... Owner's Name ..l e z '''i lit L r.—,S .. . _ . . . Phone 4L-2-42 3,9 . .......... t Add _.. City ct,ockton Pi Address spite z 7 Conirodoc's,Vome laCriarri's Sen,;je rl��l::'.; 7................. License # 2Z'9�1 Phone 45',... .048......... y Installation will serve: Residence cJ Apertment House[] Cornmercia! `;Trailer Court t Mote; 7 Othur .. .. ... ...... . . .. ',It Nomber of living units: j... Number of bedrooms %......Garbage Grinder --- Lot Six . .2_Aere3............... Water Su,rl;: Public System and name . ........... L...................Private " Charr ter of soii to a depth of 3 feet: Sand L Silt D Clay ❑ Peat❑ Sandy Loam F Clay Loam ❑ 9 Hardpan❑ Adobe Fill Material .... . ... If yes, (Piot plan, showing sizo of location of system ;n relation to wells, buildings, etc. must 3e placed on reverse side.) u'l NEW INSTALLATION: (No septic Cork or seepage pit permitted if public sewer is available within 200 feet,) s ' PACKAGE TREATMENT ( ' SEPT iC TANK Gc� Size.....s..4 X6 X 10 _. ....... - liquid Depth ......... ! ` f Cooaciry . . Type .SQ............ Material.cancrota No. portments .......2..... .. . t '. Distance to nearest: Wel150............. .....................Foundation ...... Prop. Lirw...?Q6 LEACHING LINE XJ No. of lines .... . . 2 ... . ... Long'., of each line ... .VSs. ... .. ...... Total Length ...170! t 'D' Box ..1 .. .. N'••,� Type Filter Material �. . ."... . . ..Dept ,ter Materia « iDistance to nearest: Well .. .......5al...... Foundation �5 Una ,c^?AvE PIT De th . 2J�.. .... Dicmeter ...a ..... Numbe• 2.... . ............. RodFilled Yes r... 'N o 0 Water Table Depth ............9.0.1.............................Rock Size ...2.'.'........................ Distance to nearest: Well ....10a-!.............. Foundation 7. Prop. Line 4.0_'. REPAIR/ADDITION(P-•.v. Sanitation Permit,# ........ Date ............................ w :21. Septic Tank (Spacry Requirements) ............iS ......................._.............................................._............._............. Disposal Feld (Specify Requirements} .............�.7G!....T.,aaC ,..;,.iris do .2...Pits.... 25"X.. p ..... ....... .........._. ....... . . . _..__ .... .. ... . ........................ ...... (Draw existing and required addition on reverse side) I hereby certify that I have prepared this application and that the work will be done in accordance vAth San Joaquin Counry Ordinances, State laws, and Rules and Regulation* of the San Joagain L.,cal Health District. H owner K IlCsfs} sod agents signature certifies the following: "1 certify that in the performance of tho work for which this permit is issued, 1 shall not employpen"tea such wsowner as to bee o subject to Wo`ki➢en's Compensation laws of California." Signed lr.C.. ..�7C/c. .uti.?.................. Owner i By ... 3.1.�. .l...glaakard _.. .,. ..__... ................................... Title . _..con..traatar....... ............... fIt other than owner) Z-P.. . hT SE ONLY APPLICATION ACCEPTED BY/V . DATE EUiLD:NG PEW.4i, ISSUED . ....... DAT" c a AuDITiGNAL COMMENTS ..... .................... ................ .................................. ......_ ...... ....... ... .. ... ....... ..... .. .........................1............. ...... .. .. ...... ... B3 Final Inspection by:� ,�� V.. ..... ...... .. . ...... ......... ........... ... .. ...... . . ..... ..... . .�.�..a�.�.11.� :............ SAN IOAQU:N LOCAL HEALTH DISTR;CT