8082 - Laserfiche WebLink

Home Browse Search

`o '—, APPLICATION FOR SANITATION PERMIT Permit No. --.._ /. (Complete in Duplicate) Date Issued -_--- .I-_� - Applica+ion is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance wi#h County Ordinance No. 549. JOB ADDRESS AND LOCATION: a�0•, --- == O-Q IG- ----------------------------------------------=------------- ---------•-- Owner's Name-----o ... � ��. Phone-. Address--------- ------ ...- d- / -- ----------------•---------------------------------•--------- -------------- Contractor's Name----� S-- ------ : Phone. Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units:/-,--- Number of bedrooms --0--- Number of baths --)--- Lot size -_-'L: �- L -------------------------- Water Supply: Public system Community system ❑ Private ❑ Depth to Water Table 4/,0 ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loom ❑ Clay Loam ❑ Clay ❑ Adobe Hardpan ❑ Previous Application Made: Yes ❑ No Q— New Construction: Yes r No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) e , �/ 16----.-.Material-- -------- Septic Tank: Distance from nearest well--l�,s�?-7,Q,�?istance from foundation-- -.--_. ` ® No. of compartments-----�-----------Size---�-��r--A-0j4w--Liquid depth--------6.a-------._Capacity---•��'�-iIR------- Disposal Field: Distance from nearest well.-We7jt�jstance from foundation---f: �-s---..Distance to nearest lot line`� �-f...- Number of lines-----------I---- r;----------Length of each line--------e , Width of trench----- _V------------------- f Type r . --- - -.- T e or filter material----IX-- �-R Distan oth f from f nater t l n � Notal length----- ------------------------ 93- --------------------- -- --_.Distance to nearest lot line--.��_- Seepage Pit: Distance to nearest well-!�D' s(�. 11-f Number of pits.--------/----------Lining material_:GCr�e: Diaimeter,---- ---. --Deptn.-.-.2-.�-------------- 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------------------------------------------ -------------------to nearest lot line--------- --- ----------• - - . ❑ ------•-- Remodeling and/or repairing (describe):--------- -----------------• •-----------•--------------------------------•------------------------- ----------------------------------------------------.---------------------------------------------------------- ---------------'-------------••-----_-.----------------...--•---•------- { tif that I have prepared this application and that the work will be done in accordance with San Joaquin County I hereby cer ordinances, Sta . aws and rules and regulations of the San Joaquin Local Health District. [Signed) �-� -------------------------------------------- -- --(Owner and/or Contractor) e t ------(Tale) r ---- (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY € APPLICATIONACCEPTED BY------------ --------------- -------------------------- ---------------------- DATE.. ,,--------------------------------------------------- REVIEWED '(3Y------------------------- --� ---------------- -------------- ---------- ---------------------------------------•-- DATE-----V-------------------------------------------- - BUILDING PERMIT ISSUED-------------•--------------- -------------- DATE S Alterations and/or recommendations------- ------------------------ --------- -----------------------•-----------------------------------------•------------••-•--------•-------------------- ------ �- - --------------- --- --------------••-------•----------------------•------------------- - %" -- ------•--------------------•------- = -- - ------------- ------------------------------ -r ...............7:---------------------------------------------------------------------------------------- FINAL INSPECTION BY:-.-.-- .--_-- ------- s Date.----1.ff------- "' �.----------•-----------•-•---- SAN JOAQUIN LOCAL.HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California E5-9' -5996 ATWOOP