72-433 - Laserfiche WebLink

Home Browse Search

0-)F-F,ICE USE: APPLICATION FOR SANITATION Permit NtT2__:_q__3_3. FICE USE. --------- ---------------- icomplete in Triplicate) Date issued --- --- ------ This Permit Expires 1 Year From Date Issued - --- - --- --- --------- ... ... ------------- -------- ermit to construct and install the work herein !Plication is hereby made to the San Joaquin Local Health District for a l:>No. 549 and existing Rules and Regulations: -scribed. This application is made in complicince with County Ordinance ---------CENSUS TRACT --------------------------- i ---------------- -------------------------- --- jOB .ADDRESS/LOCATION -- -----3?45--- --------------------------------------------m-------------------phone _727-57-3- - Owner's ------------- ---------------- Lockford Owner s NameDon...GTJ-mmP-tt------------------- City -- -------------------------------------------------------------------------- 116 w p .o .Box_.290-------- ---------- ------------------------------- 26�95_j----- Plhc�he Address ------------------------ -------- Tank__.�-------------------------License # ------ Contractor's Nameial FlTrailer jCourt-0. Installation--will-serve:_ --Residence-fg-Apartm enf- House, _Commerc Motel F]other -------------------------------------------- Lot Size ----- ------------------ Number of living units:...1-___---I----- Number of bedrooms ---2-------Garba-ge Grinder Private 4P ---------C-1ty------------------------------------------------------------ -------------------- El Water Supply: Public System and name ---------- [] Sandy Loom El Clay,Loam C3 Character of soil to a depth of 3 feet: Sancl'F� Silt El Clay M peat . Fill Material ------------ if yes, type -------------------------- Hardpan [I Aclobe�j W aced on reverse side.) (pl-ot plan, showing size of lot, location of system in relation to wells,csewergs uildins,available within etc. must be pl. feet,)NEW'INSTALLATION: (No septic tank or seepage pit permitted if publi200 SEPTIC TANK Size---- ------------------------------ -- --------- Liquid Depth --------------------------- 0 PACKAGE TREATMENT [ I Material"" ------------- --- No. Compartments ------------- -------- capacity - --------------- Type ----------- ------------ Foundation ------ Prop. Line --------- Distance to nearest: Well ------------------------------------ Total Length ----------- LEA.CHING LINE No. of Lines ----T------------------ Length of each line-------- ----- --- LEACHING -- -9-it ------------------- ------- 'D' Box --I-------- Type Filter Material -------V,-------_De pth Filter Material ---- ------ . i-------------- -ion-- -Property Line ----9AD Founclat Distance to nearest: Well Yes C3 -1 Rock Filled Diameter --- --------- - Number ---------------- SEEPAGE PIT j I .,Depth -------------------- --------- "-;. Rock Size ------------------------ ------------- --------- Wcifier Table Depth ........ Prop Line ......... ------ Foundation ------------------- r to nearest- -------------------- ------ Date ---------------------------------- -7 V� ION(Prev. Sanitation Permit# -------------------------------------- ----------REPAIR/ADDITION 1�1-------------------------------------- I Septic Tank (Specify Requirements) -------------- --------- C , ----------------------------------- ----------------------------- 90_!�_,-n-e-w-.Leae-h---Line�_ Xf Disposal Field (Specify Requirements) --- i . t --------- I , - ------------------ ---------- ---------- --------------------------------- ---------------------- --------------------------- --------------------- ----------- ------- ---------------- ---------------------------- --------------------- ----- ------------------w--- -------------------------------------- ----------------- " --—---------------------- -------- -------------- required addition on reverse side) (Drow existing and , work will be done in accordance with Son Joaquin I hereby certify that { have preparej,.this application and. that the County Ordinances, State Laws, and_:Rules and Regulations of the San Joaquin Local Health District. Home owner or licen he following: uch manner ture certifies tissued, I shall not employ any �erson in s sed agents signature permit is I certify that in the performance of the work for which this asto become subject to Workman's Compensation laws ofCalifornia." ------------ caner -------------------- Signed ----- -------- ------- --- I e By ------------- - --------------- (if other than owned FOR DEPARTMENT USE ONLY DATE APPLICATION ACCEPTED BY -- - - ------------------------------------ ----- --------DATE -------------------------------- IT ISSUED ------ ------ - ------------------------------------------------------ ------------------------------- BUILbINGPERM - --------------------------------------- -- ---- ----- - -- - ------------- -------- ADDITIONAL COMMENTS --- ----- ---- ----- --------------- - -------------- - -- ------------------------ -------------- ---------------------------------------------- -------------- ----- - -------------------I------------------- ----------------------------------- ------- -- -- -- -------------:- -------------- ------ -------------- --------------------------- ------------- ----------------------------------------- Date ---------- ------------------------------------------- --- -- - - --- - - -----------------------------I----------------------- --------------- Final Inspection by- -------- -- N AQUI N LOCAL HEALTH DISTRICT E. H. 9- 1-'68 Rev.