582 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT 1 (Complete in Duplicate) Applic Thisation is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION----------------1.a1-8---M_ead_QW_AYenua-- ;......Stockton------------------------------------------------------------ Owner's Name---------------------------------------------------W•---_D-•___Ma '_CTlT1aCk----------------------------------- - Phone- - - Address---------------------------- --------3 Q---Z.-_-V1ne---Stree --- --------------------------------------------- Contractor's Name------------------------------------------D• A-. PARRISH---&-SONS-1---INS ._• .-.-.-•-w------- Phone------ fr9607------------ _ Installation will serve: Residence XX Apartment House ❑ Commercial [❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units. 2- Number of bedrooms E3 Number of baths (* Lot size--�1-X20Q!__________________________ Water Supply: Public system ❑ Community system ❑ Private$x Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe M Hardpan ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well----_501----Distance from foundation_--_ 2Q1_ -_--.Material-__-_-Conc-Cjrc-Brick 11 No. of compartments-------2---------------Capacity-18-00---G-------size---560-X3, !!X6,3�iquid depth-------521!1 __ __--- Cesspool: Distance from nearest well-----------------Distance from foundation---------------------Lining material--___------_-----___-------- Size: Diameter--------------------------------------Depth----------------------- ---------------------------- Privy: Distance from nearest well-------------------------------------------------Distance from nearest building ❑ Distance to nearest lot line-------------------------------- SeepageN Pit: Distance to nearest well__1C _----_Distance from foundation-------------------Distance to nearest lot line----------------- Number of pits----------------------Lining material-----------------------Size: Diameter------------------------Depth--------------------------------- Disposal Field: Distance from nearest well--------5Qt--.Distance from foundation-----29--------Distance to nearest lot line____--5f KI Number of lines------- ---------------------------Length of each lineAxJ"-4-___7o-Width of trench---------24!!------______--___ Type of filter material--_---2--V---Rk-Depth of filter material--------�,$it_----__ -Remodeling and/or repairing (describe)------------------Nex_jn;3tall ation)•_•_- •--------------------------------------------------- ----------------------------------------------------------------------------- ------------------ ----------------------------------------------------------- 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).---- _- .-- .--- --( �Contractor) Cid �i3C-a + � $y:--- --------------=--------- -- -- ----------------------------------- -- -----------(Title)-----E'at:LImtAl---------------------------- (Plot pla , sh ing size of of, location of s em n relation to wells, buildings, etc., must be filed with this application). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY--------------------- f --=----------------------------------------- DATE--------- �- - ---------- -------- EVIEWEb BY_ ----------------=---------------- ---- ------------ --------------- DATE---- - --;�------�- ------- - BUIL DING PERMIT ISSUED-------------------------------------------------------------- ------- ----------------- DATE - ------------ ------------------------ Alterations and/or recommendations---------------------------------- ------------------------------ --------------------------------------------•------------ --------------------------------------------------- --------------------------------------------------- ------------------------------------ -- -----------------------•-- • - PERMIT No.___ --- a�ISSUED----- - ---- ---- � 34� Am �( ------- ----(Date FINAL INSPECTION BY: -- -_-r - i��/ - -------- •--------- Date-------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California ES-9-2M 9-50 W=1639