19215 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: _ Permit No. ---�•--`--Z-•�-5 _- V= APPLICATIONFOR-SANITATION PERMIT ---------"" -- (Complete in Duplicate) ------- - bate Issued __7--"-�- ~ f.This Permit Ex:tires 1 Year From Date Issued d. ---------- ------------------------------- -- A lication is hereby made to the San Joaquin Local Health District for a permit to construct and install t r�herein describe pp This a plication,is-maramP ,ncewi"t�h County Ordinance No. 54/9. r�ST ` T Zi' ' !V/ i _ vP�f__Qr� dik 'y` JOB ADDRESS AND LOCATiO -_.---- ��- Ph one___� U+� r � Owner's Name----------- W p Address :.1�= �_ . Phone---I ��-4 a------ ------- Contractor's Name--------- f � "� Trailer Court ❑ Motel ❑ Other ❑ Installa+ion will serve: Residence': Apartment House ❑ Commercial ❑ �� Number of living units; __I--- Number of bedrooms _-�__- Number of baths ---/.- Lot size ____.__ __.__ f Private Depth to Water Table--------- ft- Water Supply: Public system El Community system ❑ clayLoam ©flay ❑ Adobe❑ Harrigan ❑� Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam [I ❑ No � FHA/VA: Yes El No 91 Application Made: (If yes,date.--------- ----.1 No D' New Construction: Yes Previous App • - TYPE OF INSTALLATION AND SPECIFICATIONS: y 200 feet (No septic tank or cesspool permitted if public sewer is available within .) ` "Distance from fouldation__ . ------------ Septic ------ -Material___-l! � � ..a_. squid depth= .' ° tl� Capco Septic Ta k- .R� Distance from nearest well ._ .Q --SSze ^- lo. of compartments-- ---- ' oe Distance from foundation4K- ------------Distance to nearest lot 1`�-". G`�•- Disposal Field: Distance from nearest wellf ---- �- - Number of lines--_--"f----- Length of each line--- �G`-----��--------W�dth of trench. _ �--- ------- Total length _ i De th of filter material__1------------ g ----------- Depth - --- -- S ( -Type of filter material_ p F Seepage it: Distance to nearest weft________________"-"--Distance from foundation Distance`t--Depnearest-- oma" ice-`----- --- t • Size: Diameter-_.__J-4— P i Number of pits---------------------Lining material-- from(nearest well-----------------Distan ce from foundation--------------------.Lining Capacity_..___------- --.----'--gals. 0 Cesspool: Depth ❑ Size: Diameter- ---------=------- Distance from nearest building l --------------------------------------- - ---------- ------------ ------------------- ----- N k. Privy: Distance from,nearest well --,------------- .�s ❑ Distance to nearest lot ine----------------- - i c: ., I Remodeling and/or repairing (d sc be�' - -- � l" -C C, --- -- ----------- ----- �� " --------- ---- 1 I hereby cer t� ave prepared this application and that the work will be done in accordance with San Joaquin oun ordinances, Sta aws, and rue :jnd regulatiorfs of the San Joaquin Local Health Dis+ric+. -------------------------------- ----------------------- (Signed) ---- ---------•----- r Contractor) r a �O or Si ned t � (Title- -_- -------- �.� ---- ------------------------------- By:I _ buildings, etc., can be placed on reverse side). (Plot plan, showing size of lot, location of sysf in relation to wells, ` FOR DEPARTMENT USE ONLY ----- DATE------ �`- ` APPLICATION ACCEPTED BY-----------*- - DATE-------------- - -------------------------------- REVIEWED BY--------------------------------------------------- DATE------ ----------------�-- --- ------ ---------�_--. BUILDING PERMIT ISSUED------------------------ ----+'-^- ---- ----- ------ ---------•--------------------_ ----- ------- ----- Alterations and/or recommendations:----_- -"- Z1 I -- ----•--------------------------•--• -------- _ --- - =( - ----------------------- ---------- -•----- ------------------------------------- ---------------------- ----------------------------------------------------- ---------------- ------- -------------------- - - - --------- - / ............................--- Date.....---�------ ----. ---------------- FINAL INSPECTION BY:...--Ci--� ------- - ��'` ` r SAN JOAQUIN LOCAL HEALTH DISTRICT }24 Sycamore Street 205 West 9th Street I 300 West Oak Street Tracy,California 1b01 E.HaseUon Ave. Manteca,California Lodi,California Stockton,CaliFornia