14889 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: ----- APPLICATION FOR SANITATION PERMIT Permit No. ...,!..__.11._....... (Complete in Duplicate) ��/ ..---_---.-------. This Permit Expires 1 Year From Date Issued Date Issued ._-.-_..�/.__ ."� Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. �"-i. _. €u2- � .1! on west side. JOB ADDRESS AND-LOCATION.... ..MC___AI' hurRoad.. px40Qfnortho------------------------------d. !____ -- .,___. (TRACY) Owner's Name...Ragex...TTait']a...•---- -------•----,-------••----------------------------•------------•-----•------------------------------- Phone-------------------_---•--- Address.............995•.1i3aIae..Rd"=--•-•.lra!ay-----------------•-------------------------------------..................--•-----------------------....--------------------------------- Contractor s Name.---The--ABY sic CAH . . .D.-_T-;ink----.------ ................................ Phone...HO"--6.-3.$41.--•-- Installation will serve: Residence lK Apartments House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ �- Number of living units: 1..... Number of bedrooms ---2-- Number of baths .---1. Lot size ...ACS eke--------._------------------------ s Water Supply: Public system ❑ Community system ❑ Private M Depth to Water Table ..30 ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel& Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe❑ Hardpan ❑` Previous Application Made: (If yes,date-------:-------------) No$] New Construction: Yes No ❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest,well--5-0 -----..Distance from-foundation---- .......W_.ri-ek................... No. of compartments----------2---------------Sizd56!_x5.6 Xb3tt Liquid depth8--------------------Capacity.- 2.DO...gr3 T Disposal Field: Distance from nearest well-..Q1-.-----.Distance from foundation......10-------Distance to nearest lot tline.....�0_._.... Number of lines--------I------------------------Length of each line-------5Q T-.--._--.-----.Width of french-----a4___........ ,...:._-•-.- Type of filter material_1S.9p6__ k----Depth of filter materiall_9'!---------------Total length------------5-Qt_____________ ________ Seepage Pit: Distance to nearest well----1QQ.t-------Distance from foundation---20_t t ._ .........Dista o to nearest lot line._ ,�. _____ �] Number of pits....----------------Lining material_-RDC$------.-Size: Diameter-_ t-._.3 ..----,Depth------aQ ---.--------------- Cesspool: Distance from nearest well----_----------Distance from foundation--------------------Lining material_-.-----._--.------.-------------.-._ ❑ Size. Diameter---------------------asDepth-----------------------------------------=----------Liquid Capacity--------•-•-•------_- - gals Distance from ne"-`arest uuiI in - Privy: Distance from nearest well- g ---.----- ❑ Distance to nearest lot line------------------------------------------------ ----------------------------------------------------------.--•--••--------------------------- Remodelingand/or repairing (describe):-------------------------------------------------------------------------------------------------------------------------------------------------------- --•--•----•----••--------•--••-----••---•-•------------•--•---•-----:.*Heu-Se--•M{3ve-d----i:1-2-------------------------------------------------------------------------------------------------------------- ---------------------------------------------------•---•-•-----•-------------------------------------------------------------------------.----------------------------------------------------------------------------------- ----------------------------------------------------------"------- ----------...-------------------------------------------------------------•----------------------•-------...------------------------------------------- I hereby certify that I 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. {Signed}...T-XiP.•-I?AY...&._NIGHT---SeptiC T-a->7k-- x'V.1Ce---- --------------------------------------------------(OeYsr Contractor) ` By:------------------------------•---------- (Ti+le) (Plot plan, showing size of lot, location of system in relat to wells, bull gs, etc., can be placed on reverse side}. FOR DEPARTMENT USE ONLY APPLICATIONACCEPTED BY-------------------------- ---'-------------------------------------------------•--------------- DATE------------------------------------------------------------ REVIEWEDBY-------------------------------------------------------------------- ------- -------- DATE----------f0-,---�.�-- -�------------- BUILDINGPERMIT ISSUED-----------------------------------•-------- g --- ; ----- DATE------------------------------------------------------------- Alterationsand/or recommendations:-------------------------------------------- ---•-------------------------------------------•--------••"--"--"----------•------------------------------------ ---------------------------------------• -----•----• ------------------- ------ ---------- -----:---------------------•--•-••-•-•----------------- •----••--------------------------------------------"--" -------------------------------------------- -----------••------ ---•-- --- ---- --- -- --------------..--..-..--------•--._....-------------------------••----•----------------------------------- FINAL INSPECTION BY:. --------- Date l� -• ---- ----------- ------------------------- SAN JOAQUIN LOCAL-HEALTH DISTRICT 730 South American StreN 300 West Oak Street 124 Sycamore Street 405 West 9th Street Stockton,California . - Lodi,California Manteca,California Tracy,California Y w EB 9 REVISED 5.99 1" 6-61 ATLAS