14924 - Laserfiche WebLink

Home Browse Search

-------.�(-2r APPLICATION FOR SANITATION PERMIT Permit No. __. ,1 L�,<.. �.-� ------------ (Complete in Duplicate] This Permit Ex fres 1 Year From Date Issued Date issued .../61-„/.-_ 1 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. JOB ADDRESS AN CATION._-_-•- /} k tom, i l g t ' Owner's Name------1 g_ .e �•�-------------------- .................................... Address. f._ Contractor's Name-------- --------------------•---------------------------------- --------------------------------•--•--------•- , _ �_-----��pa`�_---..- ----- ---• -------•• ------------------------------------------------------------ Phone .............. Installation will serve: Residence p_� artment House ❑ Commercial ❑ Trailer Court ❑ Motel [3 Other E]Number of living units: _-_l Number of bedrooms—'3- Number of baths l__- Lot size _7 Q 3 Q Water Supply: Public system ,X f Y ❑ Community system Private Depth To Water Table Y_`J_- ft. Character of soil to d depth of 3 feet: Sand ❑ ` Gravel ❑ YSancly Loam ❑ Clay Loam ❑ Clay ❑ Adobe�ardpan Previous Application Made: (If yes,date__________________j No ❑ ��New Construction: Yes ❑ No [��A/VA; Yes ❑ Ne TYPE OF INSTALLATION AND SPECIFICATIONS: ;t (No septic tank or cesspool permitted if public sewer'is available within 200 feet.) Septic Tank- Distance from nearest well_____ ___.__ I __Distance from foundation--------------------Material------------•.---- 5 No. of compartments_..____-- ---•--------size------=_ ( I------------�---Liquid depth-----•-------- Capacity__ Disposal Field: } Distance from nearest well-��-_--__---.Distance from foundation__/__�___.-__•_"Distance to nearest lot line-__ .-•- ©� umber of lines.______.__I i 1 .----- Length of each line_.__%F--------------------Width of trench--- --_y Type of filter material--._Xo� ------------ N. of filter material---- "-b'-`�--------Tota! length_.._, Q.-!----,_..._ Seepag it: Distance to nearest well---- ---Distance from foundation_.- -�. ,,`___.Distance to nearest lot line_..5----_--_ m/(�rd Qmber of Pits.... Lining material__:Ycil-�(<-__-----Size: Diamet � '-/ f Depth4-••-•""----•-- ' Size: Diameter_____ -___--_--'--------'-- -..Depth_------•_ m�'foundation-------------•--'-- Lining material-------•--•-- - . Distance from nearest well_________________Distance fro Cl 'P--------------------------------Liquid Capacity ' - ge PrivY: g Distance from nearest well__.__________•.---"-----___ ---------------._Distance from nearest building Distance to nearest lot line-------------•- 9' --------------------................. = --•------•----------- Remodeling 1� / ' � -•--------------------•----------•------ __.._.5-.- -- w and or sparring--Idescnbe}:____ . -_• __J -••--•---•-----------•---- e: ________ ________________________________ ______________________ ______________ _______________________________ ___ A_.____._______...______.._�.--------------------------.------------ done accordance with San Joaquin County ! he certify that I have prepared this application and that the work will be doin ordinances, State laws a401rules and regulations of the San Joaquin Local Health District. (Si ned g ) -------------- ' = ( _____ _________________(Owner and/or Contractor) By:--------••-- '= = t�� t, r f - -----------------------rile]L/ Piot Ian, showin size of 1` location of Sys tem.in relation to we Jp ( P 9 �.�y r �ings, etc., can be I6-c on-reverse side). ' FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY_-_.____.___.-_- --•-.�I DATE.. - -- - ---BUILDNG PERMIT ISSUED! -------- DATE----•-'-----. . . Alferations and/or recommendations:.__.! d -- ----------------- •-------'- - DATE----------------•------ .__. .gyrus... } - --144C 4 )- --------- ----- FINAL INSPECTION BY: " Date-------------1 . - ., ',$AN,JOAQUIN'L OCAL.HEALTH DISTRICT, 130 South American Street 300 West Oak Street Stockton,California 124 Sycamore Street 305 West 9th Street Lodi,California Manteca,California ES 9 AEViS£p 6-59 2M 5-62 ATLAS Tracy,California