13580 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: /d:3 Permit No. _ �� '� f � G f --- -' APPLICATION FOR SANITATION PERMIT 1-C51a }a� (Complete in Duplicate) Date Issued ------------------------------------------------ -------- ------------------------------------- --- ------------- _----�--�!•�/ --------------------------- ------ --------- - - - - This Permit Expires 1 Year From Date Issue Applicatmit to construct and install the is hereby made to the San Joaquin Local Health District for a perwork herein described. This application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND LOCfCTIO :. t�- - ph ------------ �!(� _ _ . _ T ...... s on ------ ----- -- - .. cp ` Owner s Name---------------- ----------------------— -- ---- Fl w.. - Address b one Contractor's Name------------------- -- - - :. - ----------------` , Motel ❑ Other ❑ Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ t Number gunits: __!-... .Number of bedrooms : Number of baths' Lot sizeX. �--------------------------- of livin _- Water Supply: Public system 2/Community system ❑ Private 171 Depth to Water Table Character of soil to a depth of 3-feet: Sand ❑ Gravel ❑ Sandy Loain ❑ Clay Loam ❑ Clay ❑ Adobe RI/Hardpan ❑ Previous Application Made: (If yes,date--.-,,.._...--------- No ❑ New Construction: Yes ❑ No 2' FHA/VA: Yes E] No • TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if puLboc sewer is available within 240 feet.) � -----------• 7 .Distance from four}dation---`-Q--------- Matel4- --- -- ---- -------- -- Septic/Tank: Distance from nearest well_- p •ty No.'of compartments-- = _Size. --��----r- . ........Lilquid-depth-: �c�--------Ca au J Zi_.,.. ]6 .-� _ / �i -Distance from toundation__--/O--------Distance to nearest Iodine---- Dispos l' Field: Distance from nearest`�v�iell--- ,3D---V tldidth of trench .,a--f.-.-�-------------- Length l Number of lines.-.____ot _'__.. --_--f of each line.._._• = r et _ �. ... Type of`filter material...c --- ?.ft Depth of filter maternal.. .._ �--_.f-___Total ......------ •• ut. __ Distance m foundation---- - --------Distance to nearest lot line__---- .._..._ Seepage Pit: Distance to nearest well__-- ---- -- ._ Number of pits------ -------------Lining material._-. -b-----k-----Size: Dia eter_-- -------- ---Depth__., . ---------••------• \ Ces ool: Distance from nearest well.................Distance from foundation `----------.Lining material-------------.--------------- cesspool: --------- ---. ' Liquid Capacity----------------------------gals. I ❑ Size: Diameter--------------------------------------Depth-----------------------------„----=='-------- q Distance from nearest well------------------------------------- Distance from nearest building.---..-._.....-----------_.---.•--------- Privy: i l -- ---------------------------------- --------------------------- �: ❑ Distance to nearest lot line-------------------- .� k _,s- --�---- Remodeling and/or repairing �deseribe): ------------- ---- ----------------- -•---• - f -- ------- --------------------------------- ---------------------------- ---------------- --------------------------- i _ 1 ----------------'----------------------------'----'----'------- --%. --- : • ---------------------- ' _ _ _. ......................................ti___.._:____..--_._ -_'.__..._._-__._--.______-----.__..._..---__...__.f__-....__..__..--_.....- I hereby`ce�tify that I have prepared this application and that the work will 6e done in,-accordance with San Joaquin oun y ! ordinances, Sta a laws, and rules and regulations of the San Joaquin Local Health District. ; i + --------------_.__-_._ _.;_(Owner and/or Contractor (Signed--ti -- -X�vF y --------------------------- Ie] (Plot plan, showing size of lot, location of system in relation to 'wells, buildings, a+c., ca be placed on reverse side). FOR DEPARTMENT USE ONLY - A - ----------------------------------- DATE------------- '64 - -------------------------- APPLICATION ACCEPTED BY--- DATE------ q-•----------- 4 REVIEWED BY------------------------•---------------------------- DATE BUILDING PERMIT ISSUED---------------------------------- ---- - -------------------------------------------------------- Alterations and/or.recommendations:._.....-..-..-- ------------------------- ------ --- ----------- __----------•- -----•--- ------------------ ---------------- - ------------------------------- ---------- ----- ------------------ FINAL INSPECTION BY----- --- ---- - ------- ----�'--------------- Date •- -------- - # SAN JOAQUIN•LOCAL HEALTH DISTRICT 205 West 9th Street 300 West Oak Street 124 Sycamore Street 130 South American Street ,� yr Trac California Stockton,California Lodir California Manteca,California EB•8 REVISED 0.58 r.P.Co.2M 6.60