19199 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: - 4-5 7-------------------- ---- ---------------------------------------------------- APPLICATION FOR SANITATION PERMIT Permit No. . 1� 9 : (Complete in Duplicate) -Date Issued. This Permit Expires 1 Year From 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. ` ------- -------- 1 JOB ADDRESS AND LOCATION----] 45e 5 /� Owner's NameC f ---------------/-------- °----- --------------- ----- PhoneG �d� �- -rConAddress-----------•-------1-�e 1 = --------- Contractor's tractor's Name----- --------•----- a,.�-- --------------------------------------------------------------- Installation will serve: ResAence'K.#Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: Number of bedrooms ______.. Number of baths .-.__-_ Lot size ____,$__-___-___... _..-_--__.___._ Water SuPPIY� Public asystem� CommunitY system Private ❑ Depth to Water Table 6-5' ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay_X Adobe Hardpan ❑ i' Previous Application Made: llf yes,date-------------------1 No,[�l New Construction: Yes No ❑ FHA/VA: Yes ❑ Nox TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) I Septic Tank: Distance from nearest well-. .l-_-.-Distance from foundation__-_- a------.Material_--_.___-hIP _/ -P'_q_4--/-------. �]i' No. of compartments------ ------------ _.--Liquid depth__.--- _7------------Capacity---- BU Disposal Field: Distance from nearest well---j"p......Distance from foundation---X$- -_.+__.Distance to nea+est.lot line.-__- -fir-- Number of lines:-_.=.:�____________ Length of each line----3-1i-- r- ?vVidth of trench------ -� ---------- Type' of filter materiaL� --- -----------Depth of filter matenalAP-_------------------Total length-.---------�e_-_:- _____________-_---- V . Seepage Pit: Distance to nearest well_.---x'10_------_Distance from foundation_-__--�"�---_-Distance to nearest lot line----3_-_-.--_-.- N �' Number of pits.----.'�----.-_--_-Lining material--- Diameter._..Z_fE__ epth____l __�--------------- Cesspool: Distance from nearest well-----------------Distance from foundation-----------------:_.Lining material--.--------_-..--__-._-____-____-__-_ 3 i ❑ Sze: Diameter ik------------------------------Depth---------------------------------------------------Liquid Capacity - gals. {: Privy: Distance from nearest well________________________________ ___ __________Distance from nearest building------.---------:--------------- _________ El Distance to nearest !ot line - `' {0 ;r s Remodeling and/or repairing (describe):- -------------------------------------- -------------------------------------- -' 6 - --- - -- -- - - _ � 1 -----------------------------------------------------------------------------------------------------------•__-_--_--.--.---_---.--.--___:-- --_--!-----___--_-_--_.--._-___..--__.-__-.-_.-_---___.-------------._--..-__- ' ------------------------------------------------------------ I, l hereby certify fl at-I have preps ed`4his application'and'Aaf-the woFk will'be donC in accordance with San Joaquin County ordinances, State laws, acid rules and regulations of the San Joaquin Local Health District. {Signed)-- - nn,r,AA caner and/or Con+ract 'J �-' - = ------- ---------- -- --------------- ----------------------------------------------- -.(Oos) By:------- t --------------(Title)------------------------------- - ------------------------------------------------------------------------=---------------------- (Plot plan, showing size of lot, locationrof system in relation to wells, buildings, etc., can be placed on reverse side). .t FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED $Y -": -C�- -- -------------- ------ --------------------------------------- DATE----CO--'-- ---O—�---------------------- REVIEWEDBY--------------`------------------------------ ------------------------------------------------------------------------------- DATE-------------------- BUILDING --- --- - -----BUILDING PERMIT ISSUED,----------------------------------------------------------------------------------------------------- DATE--------------------------------- Alterations and/or recammendations:+i _ -___ "`:-- __-- _ F------------------------------------- -------------------------- --------------------------- ---------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- i --------------------------------------------------------------- _ _ _-_- --.-_-___--_-.-___--___-_._--.-----...----------_----__-_-_-_._-----_-_-_-.-____-.-_--_.__--_ _ FINAL INSPECTION BY:...... ...�. --------------- -------------- Date-.----- -1 -' ` &,5 SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazelton Ave, 300 West Oak Street 124 Sycamore Street 205 West 91lr Street Stockton,California Lodi,California Manteca,California Tracy,California j F.P.0 C. J,