19880 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: T - -- -------------------=------------------------------------- APPLICATION FOR SANITATION PERMIT Permit No. --- -------- --------- (Complete in Duplicate) Date issued ------------ ----------- -------- ---- -- This Permit Expires i Year From Date Issued - - 2yf-2-&0.-4� 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.-541?. JOB ADDRESS AND LLOCATIbIO -----1F!---- 'il/ L ---- - �,� oN'Zar _-----------------Uqw:n h Owner's Name------------ZZON R-0---------N Phone Address 17-71......M_F_PuDi Q_�( ,4 1� _ _ ) CRIni- -. Contractor's Name--------- -------------------------------- ---1-1------------------ I---- ------- ------------- a 4 ❑ � �' ❑ Motel ❑ Other ❑ Installation will serve: Residence Apartment House ❑ eC�Ommercial 4 Trailer Court • /A .t- - .y ..� 0� Number of living units: __j---- Number of bedrooms _ ._ Number of baths -- Lot size' CR�� _ _________________________ F Water Supply: Public system ❑ Community system ❑Private [tg-'Depth to Water Table!/6_ ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam [E] CI ay Loam Clay ❑ Adobe ❑ Hardpan ❑ Previous Application Made: (If yes,date-----------,--------I No New Construction: Yes ❑ No 0-`FHANA: Yes ❑ No 2''`� TYPE OF INSTALLATION AND SPECIFICATIONS: i I - (No septic tank or cesspool permitted if,public seweriis available within 200-feet.) II. U r Septic Tank- Distance from nearest well-----------------Distance from foun8ation-------------------Material----_..__._____.________.____-___.__...__--_--_. g�x "i`l f4 ` No. of compartments------------_----------_-.-.-.-_.Size------•s - - + --- ----Liquid Li u id de th--._-------------- --------Capacity---- ---------------- Disposal ------------ Dis osal Field: Distance from nearest Distancefromfounation__ Tf �� / ........Distance to nearest lot line___._________ Dia Length of each line------A90------------LWidthh of,trench......33.-14-------------- �. �C Number of lines__________ff d` Type of filter materiaf--hQGDepth of fuer material____. __ g _-------Total fen th--------------------�4 ---------- Seepage Pit: Distance to nearest well______________________Distance from foundarion: ._.Distance to nearest lot line--._-.-__________ r ❑ Number of pits----------------------Lining material--_ -- - ------------Size: Diameter_ #-------_-.---_--Depth-------------------------------- Ce5spool: Distance from nearest well-----------------Distance from foundation .-____----I -__ Lining m9aferial__._.______.__-_____._..__.._____ U--- _ __ - __Lei' uid Ca acit 1 �*❑ Size: Diameter--------- ----.Depth-------- ------------------------ -------�''-- q Capacity - -- -------------------9a Privy: Distance from nearest well____________________________________ ____________Distance from nearest building* -- 0DistDistance ance to nearest lot line j # Re �m deling and/or repairing (describe):-- -------------------------------- ---- - ---------------------------------- ----------------- ------------------------------ -----------------•----------------------------------------------------------------- --------------------------------------- - ----------- I - " - ------------------------------- ----------------------- - -------------------------------- h hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin Count ordinances, State laws,,`a�nd''rules and r ulations of the San Joaquin Local Health District. ------------(Owner and/or Contractor) (Signed) ------- ------------------------- BY: ---------------- --------------------__- ---------------:-:-----_---- -------(Titled--:------------- ----= ... (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). r FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY--------h.k-O-------------------------------------------------------------------------- DATE-- I�`-.��z-=�. --------------- - REVIEWEDBY- ----------------- -------------------- -----•--. DATE------------------------------------------------------------ BUILDINGPERMIT ISSUED-------------------------------------------------------------•------------------- - ----------------- DATE--------- ------- --------------=------------ ----- ------ Alterations and/or recommendations:.---__/ �M� F__N__D----____T_-H!�'T___S _IPT1C___--TAWK___1Q_�__-_pV.tL'l.P—D r ------- f�QgHT`T..?`�------- � .. 1 111�F„C. -------90-0-----aA,6 ..._..M1V6-1Z_a.....W.jTH --------U-ND_14a�l��> a1-Ib- ----- tl-0Y-t�=-D------ -------- --- FINAL INSPECTf7- = Date---------I �----------------------- - SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Haieltan Ave. 300 West Oak Street 124 Sycamore Street 205 West 91h Street Stockton,California Lodi,California Mantecar California Tracy,California F•P.CO.