Laserfiche WebLink
r /7��r - ' y PERMIT hW Permit No. x:I- <br />����-- APPLICATION FOR SANITATION w <br />II (Complete in Duplicate) Date Issued <br />� <br />This Permit Expires, 1 Year From Date Issued <br />tt �0AA ork herein described: <br />.. , <br />Application is hereby mode to the Son Joaquin Local Health District for a perrr>t¢>cas c an a <br />cmc <br />This application is made in complian with Cou rd;nance t 9 - <br />d- <br />JOB ADDRESS AN ATI ---- Phone.__._......_....._...__..._ <br />Owner's Na .........._ <br />`.-._..1.......,_._.i ------------------•---•--.... <br />•. }} <br />Address i Phone <br />Contractor's Name ................. Trailer Court Motel Other ❑ <br />Apartment House ] Comrr ;al ❑ 4 <br />installation will serve: Residence ❑ AP Lot size ..-- .•---��% 7 7� <br />Number of bedrooms.. -a'! Numbed of baths _ -, <br />Number of living units, . , _ _. {t• _ <br />z , pr',vate � Depth to Wafter Table - <br />Weter Supply: Public system ❑ Community system ❑l <br />' i Clay Loam ❑ Clay ❑ Adobe( Hardpan ❑ <br />Character of soil to a depth of -3 feet: Sand ❑ Gravel Sandy Loam ❑ Y <br />Previous Application Made: Yes ❑ ,N <br />New ConsFruction:--Y�s0 NO ❑ FHA/VA- Yes ❑ Not <br />tiR <br />L ATION AND SPECIFICATIONS: <br />TYPE OF INSTAL <br />(No septic tanli<"or cesspool permitted if public se�+ar is available within 200 feet• � <br />ndatign.---(40 ........Matena� .._ <br />Capacity-. <br />Septic Tank: Distance from nearest w I--•- i'_.p1Zeance ryAx�° wVLiquid depth__.-..- <br />No. of compartments. .. ---- --- ¢ <br />�Q Q.... Distance from founds n_.._.lD--••- Dist�ance�oo represt lot lire.....---•- <br />' Disposal Field: Distance from nearest well, � jar ,fdF6�ch..••.-•'�•- <br />7 Len th of each line._ <br />Number of lines ................. .. .rte otal length.._ :..r.��. <br />Typ oafilte� r material... _- _ ; . Depth of filter mater;a4....,/'� -- --:> .. / <br />�/ I <br />5 l # 1 it nclat;on. _.D.k.---- Di tante to, nearest lot lin �..------- <br />Distance ro <br />Seepage Pit: D�stl#ante to nearest ell.-,� ize: Diametr.-.--_...... peptn. :- <br />Linin material - �� a Q <br />Number of Pits -.7-1 g <br />F. 1 �•, <br />Di` ... - - ......................L;9L;d Capacifiy.: .:_.... <br />stance from nearest welt-----------------�pistan�e from foundation.._.._._.. --;-----•Lining matena__.--�---.-•-------•----tifig•'-` <br />Cesspool: i Depth._:'• -..._..-.rte,.. <br />Size: Diameter..---- ' -------__......_.• # ----`-----•-• -•••-••--- ----t----- <br />❑ _•._• Distance fromtneerest building__._ <br />Privy: Distance from nearest well...__+... --------•-------•--••- M.. <br />-� <br />❑ D�stl <br />tance to neareslt lot line...... ............ ........................ <br />--..---�-___-• <br />'� SI i ... _.._.. • --- <br />... ----- k i ..........................••••.. ... <br />Remodeling and/or repairing._(describe�: d; ij....�.._. ------------ --•----.l....... --------- <br />..... ...... ..._.........---•- <br />I ........-•--........... ....... <br />......... . =- .- .. •--•--...._...-------- . <br />t <br />I <br />- <br />I I� l ...... <br />............................ <br />---- •---•••• ......•• -- l u--•-- ---------------•--------------------•-- .............. -• ..-.---•-••- <br />1..,..------ "_----------------------- <br />hereb certify that I have p�epered this application and +fiat the work will be done. in accor�dan—ce-with San Joaquin County <br />State iaw's_,:a les and 1regulations lof +he San Jaaquln Lo ,ealth Dis+gra ty/� �Contractorj <br />ordinances, q, r� ''� ne n <br />in 1 _---•------- <br />`' .(Q <br /># r -• <br />a ------: ---- ••.......... . <br />(Signed). . <br />------------- ----- t <br />Title <br />laced on reverse side). <br />By: _--_-------- ze <br />i � kruildmgs, etc., can be p <br />f (Plot plan, showing siie'of lot, location of system <br />n relation to w� lls, <br />---� 1 FOR DEPAWrI.IENT USE ONLY--��-,_ I <br />kDAT+ » <br />APPLICATION ACCEPTED BY. - ...: /.►! --- 1•----------------'---- ........----- . D,°:TE_........._........_. .._..... <br />DATE <br />REVIEWED By ----------- i - t ----- - ._...- <br />BUILDING PERMIT ISSUED...._...._--•........ •-••....._.-•_----. <br />AlFerptions and/or recommendationsd_........... ..... .. �El__..:_..... - -� F ............_.. ...... <br />.:: <br />•.... .... ........... <br />trr .." <br />I <br />3 <br />1, ......••- <br />} <br />{ .. 11 <br />I .---...- <br />s ... _.. -a �- <br />_.----- <br />Date.... ................... <br />FINAL INSPECTION BY:.. s..--•• _� <br />SAN JOAQUIN LOCAL HEALTH DISTRICT <br />-300 Wort Oak Street <br />130 South Amariein�5try �- j Lodi California <br />Stockton, California <br />132 Sycamore Streat <br />Manteca, California <br />F5.9 -2M Revised 6_'59 F CO- <br />— - <br />$14 Noah "C" Street "`^ <br />Tracy, California <br />