68-270 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT Permit No. , .....-.'.. � y -------- -•-----------------_------.-------- ------ -- (Complete-in Duplicate) Date Issued _.................,--.. .--..-..--._--. _--_----.--. This Permit Expires 9 Year From Date Issued Application is hereby made to the San Joaquin Local Health District for permit to construct and install the work herein described. i This application is made in compliance with County Ordinance No. 549, t JOB ADDRESS AND LOCATION-460-6.0 -----<FAS—r------M-0 4- ----------- / ------------ ------- Owner's Name------- Address-------------------•-•----------------------- �� i� � Contractor's Name -��5 !Z �.J-�1 S - ----------------- ----------- PhoneC1f Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel [] Other ❑ Number of living units: __j---- Number of bedrooms -y Number of baths--1----- Lot size . f/ _X-ZDO--.__--------------------- Water Supply: Public system ❑ Community system ❑ Private E& Depth to Water TaUe,�..� ft Character of soil to a depth of 3 feet- Sand Gravel Sand Loam Clay Loam C€a Adobe Hardpan P ❑ ❑ Y ❑ Y �, Y ❑ ❑ p ❑ Previous Application Made: (If yes,date_----------------- ) No (gJ New Construction: Yes ❑ No M FHA/VA: Yes ❑ No�( TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) g / J*Septic Tank: Distance from nearest weft---7- ---------Distance from foundation.l._.O.---------Material ....... .. .. .. .. . ... ... ...... No. of compartmentsc,--/ ...... -._.:...Size-A-A-�j-,A.47-.-:--_Liquid depth....- Z .__ ......Capacity_flo , s p Disposal Field: Distance from nearest well.g„r....1........DTstance from foundation_..�Q__J*--_.-.Distance to nearest lot line..____� Number of lines_C2 _ _______ _ ____-----Length of each line._..!`. ._._ Width of trench-----�*-.-_-_.-------------- r ri-------- Type of filter material- .. .... ........Depth of filter material____-�. -------.-----Total length----1-40.9------.-__--.---------.--. Seepage Pit: Distance to nearest welL./4s_--------Distance fronb foundation---l.,?-_-.-.-.Dista ce to nearest lot line ______ Number of p,ts-. .-------- Lining material-R41.6-4------- Size: Diameter___ 3. ----Depth-_- -------- Cesspool: --- -Cesspool: Distance from nearest well ----------------Distance from foundation- - - _ Lining material----------------._____-----------_.-_. ❑ Size: Diameter- -- --------- ----- --------------- Depth----------------------------------------------------Liquid Capacity----------------------------gals. Privy: Distance from nearest well-------------------------------------------------Distance from nearest building----------_- .-----.-_-------.----.-.---- ❑ Distance to nearest lot line ---------------------------------------- Remodeling and/or repairing describe :.-_ --.-__ - &------ --------L---------------- ------- ------------- --••----------------------------------------------------------------- ------------ -------------------------- I - - I hereby certify that 1 havere ared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rul�s a d regulations of the/SanJoauin Local Health District. (Signed)------------------- ------ -•------ - ----- ---- - - -- ---- ---------- � ------------------(Owner and/or Contractor) BY:-------- -----.. ------�'( -- - ---- ---- ----- --(Title)------- - ----- --- - '---------- ---.. ................. (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be place on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY--. '------- ------------------------- ------------_ DATE =��.------------------ REVIEWEDBY------------------------------------ ........ . ---- -- ------ ------------------------------- ------ DATE-------- --------------------------------------------------- BUILDINGPERMIT ISSUED---------- ----------------- ---------------------------------------------------------------------- DATE.- ----------------------------------------- Alterations and/or recommendations:---------- ------------ ------ - - - -- - --- ----------- - ------------------------------- ------------------- ----------- ----------------------------- -------------...................... •------------------------------------------------ -------- --------------------------------- ----------- ---------- ----•------------------------•---------------- ---------------------------- - -- ------------------ --- ------- ----------------- --- ---------- -- ------- --------------------------------------------- ------- ------------------------------------- F€NAL INSPECTION BY: - - f ................... SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Ma:elton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi, California Manteca,California Tracy,California E.H.92M 1-67 Vanguard Press