Laserfiche WebLink
! FOR OFFICE USE: <br />------------------------ <br />-'-'---�'�f'����- ------ <br />� �� � | <br />i--------^--'..--'_--. <br />APPoC4oIdN-FOR SANITATION PERMIT <br />M�vmp|�eUnT�p4�mm) Perm <br />(Complete `��_' <br />This Permit Expires I Year From Date IssuedDo��hnum6-���������x <br />Application is hereby made to the San Joaquin Local Health District for o permit to construct and install the work herein <br />ooasoeu. This application iomade incompliance vvkhCountyO,6inonito No 549 and existing Rules and Bpgnkxdmna <br />Installation will serve: Residen artment House C] Commercl I OTrailet ourt tl <br />Number of living units..--./ ------ Number of bedrooms Z Garbage Grinder ............ Lot Size <br />Water Supply: Public System and name --_--._..... --------- -------------- ........ ---------------------- .............. ............. Private <br />[6oract�,of soil toodepth of3feet: Sand 0 Silt [] Clayx Peat O Sandy Loam -F] Clay Loam E] ` <br />Hardpan [j Adobe:(] Fill M�todo|-.---'|fyes, type .......... ................. <br />(Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side.) <br />(No septic tank or seepage pit permitted Kpublic sewer |oavailable within 20Ufant) <br />PACKAGE [J SEPT|CTANK{] =-�� Uqu|6 Depth ----------------- <br />Capacity <br />-- <br />Copndry./20.0 _' Type uL-^�------- No. Compartments .-�.�-~--.-- <br />CU�onco to Well --�����l.=---_- �'�� r~ '�- g <br />LEACHING LINE �� .... ^~ � <br />1-' <br />Distance to nearest:o�. VVWell^�w^~� <br />- -- Foundation 'Z0_.~+ ........ Property Line <br />SEEPAGE PIT � [ ) Depth - ...... Diameter .3.4-'" --- Number ' -------- ^� FilledYes No.(:] <br />VVuh,r To6|o Dap+h--x��~5�.--'_------- ...... _Rock Size <br />'^��'�� <br />Distance +onearest: Well ..... ^����.�------.--Foundation ....... Prop. Line' .............. <br />REPAIRADDITION (PrevSanitation Permk#'----------------- -'-'--_-'- Date ----------------------- -__j <br />Sep»icTonk(SpenfyRoqvi,emenm).---------_-.------.-_-----__---'_',------_---_-_'_._ <br />Oi,pu,o Field (Specify Requirements) --- ----------------------------------------------------- ____.___________................................. | <br />-----'--'--''�----'--------------'--'---'----------------^------'^ �v <br />v <br />----__---_--.--------------- -_'_-_'-.__-__--'--'----_---_-.__--------'' <br />UDrovvm�,hngand ,oqvi�6od6ihnnop,ovameside) <br />| hereby certify that { have prepared this application and that the work will be done in mw«wrUmmoe with Son Joaquin . <br />cwomry Ordinances, State Lwvvv and Rules and Regulations wf.N`e. Sao Joaquin Kwmml Health District. Home mnvnmr or licen- <br />sed agents signature certifies the following: � <br />"I certify that ihperformance <br />In such manner <br />w vww r <br />SignE <br />By �� <br />� ow r) <br />. <br />APPLICATION ACCEPTED BY ... R MENT USE ONLY <br />--_-----'_--.—._—'_-_--'-- <br />------------------------------------------------�������������� <br />��-` <br />Rno!|n, ---'-'`-------'--------'---' -- ^ <br />Inspection - -''-_''_'-----'---------_'.Do�-.+������� <br />' J�A�U|N LOCAL HEALTH Q|�TR|CJ ~ /' <br />� .| <br />E.H.P 1''d8ev. 5A8 - � <br />