76-53 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: 3APPLICATION FOR SANITATION PERMIT II (Complete In Triplicate) Permit No. �`..5 7 This Permit Expires 1 Your From Date Istued Date Issued -.-` . Application is hereby made to the San Joaquin Local Health District for a permit to construct and Install the work herein i described. This application Is made in compliance with County Ordinance No. 549 and existing Rules and Regulationst 2269 S. Hollenbeck Road JOB ADDRESS/LOCATION .............................................................I.._...._.. ............ .....CENSUS TRACT .........._.............., Owner's Name _.....Jimmie-•-Winchell Phone ..- ...............................................:.:.:.............. . --------------•- Address Ci`"' Stockton --•------ 83.11 ...E/ Main Contractor's Name __.__.ROTO -R00' ER�EWER__SER. Contractor's ....::;:License #2 _..__...__ Phone _465.-2616 Installation will serve: Residence]Apartment House(] Commiie civil[]Trailer Court I-] Motel ❑Other---•----------------------------------------- Number of living units------ Number of bedrooms -3---------Garbage Grinder .__.Ye.s- Lot Size :_2...acres plus_____ Water Supply: Public System and name ___ Private ED Character of soil to a depth of 3 feet: Sand o Silt❑ Clay 0 Peat❑ Sandy Loam 0 Clay Loam ❑ Hardpan❑ Adobe fn Fill Material .1}-0....:. If yes,type ............... . (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. "must be placed on reverse side.) NEVl1`INSTALLATION: INo septic tank or seepage pit permitted if public sewer_is.avallablewithin 204 feet) T' PACKAGE TREATMENT ( l' SEPTIC TANKt Size..4-!-. '--•-x_-9?---------------- Liquid Depth _V-4!................. Capacity ----120.0 Type ._--prei.astMaterial_..concrete l o. Compartments 2 6 last to �; Distance to nearest: Well ------------------------------------Foundation -----------.-_._----__ Prop. Line --------__._____--_..- LEACHING LINE [ No. of Cines ..2___________________ Length of each line-9-0-1....90-1----------- Total Length ....18C i..............� 'D' Box.... eS. Type Filter Mater) l .. 'Q�k.......Depth Filter Material 8 . ter aeral ___:1 .!f. ; 1901 to 5.1.. ............... Distance to nearest: Well ........................ Foundation ........................ Property Line ............I........... � Water Table Depth cr ............:Rock Size __..-�•-..•-•.�•ock Filled Yes [3 No �] SEEPAGE PIT Depth 2-- ------------ Diameter Number - .----------•--- Rock 0 p 108 12 x 5 r ---•-Foundation--------------------- Prop. Line s......._.. Distance to nearest: Well -•--�--�--------------------- 101 � ---.-...- REPAIR/ADDITION(Prev. Sanitation .Permit# ---.----.----------------------------------- Date .................................. j h Septic Tanis jSpecify Requirements) -------••-----•...........................................------•--------------•----.�C f Disposal Field (Specify Requirements) --•------------- ---------------- ............................................................ -- ------------------------------g--------------------------••----------•----------•••-----•---....-.----••----------•--------.........-------• . -....._....._............---•-•-••••------ -----------------------------------------------------.------ ---------'--------'----------------------'----- ------------ ...... (Draw existing and required addition on reverse side) 1 hereby certify that 1 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. Home owner or licen- sed agents signature certifies the following: ".1 certify that in the performance of the work for which this permit Is Issued, I shall not employ any person in such manner as to become subject to Workman's Compensation laws of California." Signed --------------- ----- ---------------------- Owner By ------ •---------- ----- ---- - Title ..Con.tr.ac. o-�' '---..._. _G - ( er t an owner) OR DEPART ENT USE ONLY �� rr ` APPLICATION ACCEPTED BY _-- --------------_... DATE ..�...:. .v..._._.:------___--- -------------- -- BLiILDING PERMIT ISSUE© .................. _.__._©ATE --- .. ----- ...........................•---...--------......................... ADDITIONALCOMMENTS ------------------------------ ..................--•........---------' --------...........-- ---- --•-------...---...---•_._.----------------------- •----------- -----• ---- -------_'---- ------------------- --------- --••-- ----------------...__._...-•----._........-................. ....................... ----- --------------------------------- -.-. ._ �- Final Inspection b Date ---- ---------------------------------------- p Y= - ..--_-------------------------- g! 13 2!, 1-68 rev. Sal JUAOUIN LOCAL }-HEALTH DISTRICT 8/7h 3M