2002 - Laserfiche WebLink

Home Browse Search

I APPLICATION FOR SANITATION PERMIT (Complete in Duplicate) 00'l- Skp 17 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. L(6,5 C',') A-"is - - back of 276 Club JOB ADDRESS AND LOCATION---------Nor€h-W9LV1r--corner__ Owner's Name------------------------------------------ ----Hd_'S --------------------------- Phone---- - - Address-----------------------------------------------------27Dt_X=foTd_AVe------------------------------ Contractor's Name }+ ---------------------------------- ------ Phone--- -960_7------------------ Ins+allation will serve: Residence & Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ F Number of livingunits: Number of bedrooms y ❑ Y Y ❑ Ea'. Number of baths M_ Lot size_-----�'_Arg______________________________ ----------- Wa+er Supply: Publics stem Community system Private Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam [] Clay ❑ Adobe[X. Hardpan TYPE OF INSTALLATION-AND SPECIFICATIONS: — (No septic tank or cesspool permitted if public seyrg V available within 200 feet.) Septic Tank: Distance from nearest well------------------Distance from foundation-----10t--------Material..,:_0-_C--Brtak----------------------- It No, of compartments_____________ ____ ------Capacity.--_ d °_ �5ize_-_ 6KW36nx3_'ff'-Liquid clepth__"�52{------- -- _- Cesspool: Distance from nearest well-----------------Distance from foundation--------------_---.Lining material------------------------------ F1 -__---____----_-- -----_❑ Size: Diameter--------------------------------------Depth---------------------------------------------------- Privy: Distance from nearest well-------------------------------------------------Distance from nearest building---------- ------______---------- ❑ Distance to nearest lot lire---------------------_-____----____-,__________ Seepage Pit: Distance to nearest well----------------------Distance from foundation-------------------Distance to nearest lot line-_--__----. ❑ Number of pits------------p;_4-Lining,material-----------_-----------Size: Diameter-------------------- -__-.Depth----------------- _ _Disposal Field: Distance from nearest well-- - on from foundation___-_-_14------Distance to nearest lot line_____51 ___----_ ~Number-of-Iin-os`° �-_----��Latrg�N�r�c>f-each�l�r+e�� 184 !=-.W/idthrof��:ec}sh,--_.---• Type of filter material----_ --Rk----Depth of filter material-- ____.- w � - .�-, Remodeling and/or repairing (describe):-------------N :i13st8,7,1$ti0]x------------------------------------ --------------------------------------------=----------------------------------------------------------------•---- a -------------------------- -----------------------------------------------------------------------,------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- J ` I hereby certify that I have prepared this application and #ha+ +he work will be done in accordance with San Joaquin County i ordinances, State laws, and rules and regulations of the San Joaquin Local Health District,. (Signed)__._---_--D -A• P H & ONS INC• • - -------i ------ ----------------------------------------------------------- ( Contractor) BY:-------- ------ -------- --------------------------------------------------- (Title) EStimafior_ (Plot plans, shows size of lot, location of sys m in relation to wells, buildings, etc must be filed with this applica#ion). FOR DEPARTMENT USE ONLY APPLICAi TION ACCEPTED BY-------- DATE --- - ---- -- -------- REVIEWED BY DATES - S -------------------------- BUILDING PERMIT ISSUED ----------------------- ---------------------------- ------ DATE_ -------------------- Alterations and/or recommendations-------------------------- ----------- _-- __ -------- -- * - '- � ' , ------ Y i ------ --- -- - ---------- ----------------- _ ------------------------------------------------------- ----- - ---- ------ -------------------------------- -------- ------------------------------------------- -------------------------------------------------------------- � /f --- -------------_------- ,19 RERMIT No._ --�`-__-- ISSUED----_ f_ ----------(Date) FINAL INSPECTION BY-- ------- ----,._~I' '_ ----------------------------------------- Date------ _ `•. 1 -------------------------- ------------------ I SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California ES-9-2m 9-50 W-i 639