Laserfiche WebLink
.............. - ....... ...... <br />Applic.stion is hereby mo <br />a to the San Joaquin Local Health District for a permit to construct and <br />JOB ADDRESS A LOCATION____CZ., <br />Owner's Name . <br />Address .. <br />Contractor's Name <br />' <br />Installation will serve: Residence 0 Apartment House 0 Commercia <br /> Trailer Court 0 Motel • i <br />Number of living units:''.1.et.4% Number of bedroorns.)!LF... Number of baths Lot size .......1. \it si ar) <br />Nato( Supply: Public <br />system t;i4, Community system 0 Private 0 Depth ro Water Table ........ft. <br />Character of soil to a depth of 3 feet: Sand 0 Gravel 0 Sandy Loam 0 Clay Loam 0 Clay g[ Adobe 0 Hardpan Ci <br />Previous Application Made: Of yes, date ........ ........ ) No <br />g New Construction: Yes IEL, No 0 FHA/VA <br />: Yes 0 No 0- <br />TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br />t <br />SepticTank: Distance from nearest wel17.71C0-......Distanceafrom foundation__ <br /> ............... . ..,.;,....;,._ a._. ..e.--e.-.. <br /> <br />.. ...... . 4:t _C-7 Cif Cti <br />No. of compartments _ .. 77)--"' Size. Liquid cie -Ivlat ri .... Capacity_ <br />........ <br />Distance from nearest well .7711-43...„ Distance from foundati ........Distance to nearest lot I; <br />Number of lines )......Length of eachline....... . _ ........Width of trench__ - ............ <br />I C.1 <br />Type of filter materiel.. ....Depth of filter material..._ .............. length..._..— ..... ._ ............... k <br />Seepage Pit: <br />Distance to nearest well_____ .......... _Distance from foundation ................... . is <br />el <br />to riearetst lot line ............... .. P.4 <br /> <br />0 Number of pits Lining material .......................Size: Diameter Depth__ ....... ......". ...... .- .... <br />Cesspool: Distance from nearest we'll Distance from foundation Lining material............................. <br /> <br />0 <br />Size: Diameter ....... ...... ......... .----.....Dec.)th . .. <br />Liquid Capacity.._ .... . ... ----_-...gals, <br /> <br />Privy: <br />Distance from nearest well... .... --.....,..„--------.. ...... Distance -from nearest building— ...... -........-.-- .... : .. -.-. <br /> <br />0 <br /> <br /> <br />Distance to nearest lot line.. ...... ----------- ........... .... .......... . ..... ........_ ...... .„_. ... .....-____------- ...... . <br /> <br />Remodeling and/or repairing (describe): ............... ......-....-_-_ .......... ----,--.. ..... --- ................... - ....... <br />'''' <br />-----....7--__ .. ..------• ' <br />c., <br />Disposal Field: <br />R OFFICE USE <br />ppr ation is made in compliance with County Ordinance No. 549. <br />APPLICATION FOV'§A'NITATION PERMIT <br />(Complete in Duplicate) <br />This Perrn <br />ate I d ssue <br />0 Other 0 ...... 4 2 ...... 5 <br />Permit No. / <br />Data Issued <br />install the work herein described. <br />•••• <br />j .t I have prepared this application and that the work will be done <br />in a ccordance wiTh San Joaquin County - <br />nd rules a <br />ulations of The San Joaquin Local Health District. <br />By- . <br />(Title) (Signed)..... <br />(Plot plan, showing size of lot, " of <br />system in relation to wells, buildings, etc-, can be placed on reverse side). <br />_— T <br /> <br />. - <br />ARTMEN USE ONLY <br />APPLICATION ACCEPTED BY.. <br /> .— — - DATE b -- <br />REVIEWED <br />E .... .... <br /> - 1 • 90.• <br />DATE.................................................. <br />BUILDING PERMIT ISSUD 0.4. <br />---- <br />DAT E <br />MOO. . <br />Al <br />terations end/or recommendations: ....... . . .._.....,-.„ ...... ..,. ....... .._,....... ..... - ..... ------------.....--.--- .. -.. ........... . ..... ---------. <br />... • <br />. - • WOW,* <br />. .... <br />1. <br />0.14.4..... .... <br />.4.1 <br />I hereby c <br />ordinances, St .... ...(Owner and/or Contractor) <br />FINAL INSPECTION BY:. <br />130 South ricinorican Strait <br />Stockton, California <br />ES 9 REVISED 0•59 2M 5.62 ATLAS <br />1. ILI AOR <br />Date. <br />SAN JOAQUIN LOCAl......).-IEALT/1 DISTRICT <br />124 Sycamern Strobl <br />Mr:inflicts, California <br />300 Wirst Oak Sava <br />Lodi, California <br />205 West 9th Shoot <br />Tracy, California