68-150 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: ------------------------ ---------_----_--- ____.___._. APPLICATION FOR-SANITATION PERMIT Permit No. .Y1- -__1iS`� (Complete in Duplicate) ----------------------------------------------------- - This Permit Expires 1 Year From Date Issued Date Issued _..''*�� Application is hereby made to the San Joaquin Local Health District for a permit to construct and install th r1c her ,ftes c,,bed. This application is made in corgpliance with County Ordinance No. 549. q. �--&M ��t.[r�3te J,_�-.A JOB ADDRESS A D LOCATION.t Vwlzr/v"Icx� �-y�- --------------------------------- -------------------------- Owner's Name C� / � f �� 0. < Cj Address -A_ _ - ' 1 ---- �� Contractor's Name------O-VuIAM—rik------------------------------------------------- ------------------- 3 � v 1 Installation will serve: Residence ❑ Apartment House ❑ Commercial [r Trailer Court ❑ !Motel ❑ Other Dl Number of living units: -------- Number of bedrooms -------- Number of baths __/.... Lot size ___J_A_<�------------------------------- Water Supply: Public system ❑ Community system ❑ Private [K Qepth to Water Table _'7.- ft. Character of soil to a depth of 3 feet: Sand eGravel ❑ Sandy Loam ❑ Clay Loam [] Clay D Adobe❑ Hardpan ❑ Previous Application Made: (If yes,date-------- ---------) No [ New Construction: Yes ❑ No FHA/VA: Yes ❑ No ❑ T.YPE OF.INSTALLATIOI9_AND SPECIFICATIONS: ~ (No septic tank or cesspool permitted if public sewer is available within 200 feet.)�-'�- y� s Septic Tank: Distance from nearest w�gll__!- _____-.-Distancce from fo undation_0D_---..--__-Material& �F" T _ No. of compartments------------------------ Size9 .� _ .f1�7._._Liquid depth._.414?-.___.--._.___Capacity, ------- ---- Disposal Field: Distance from nearest well-A- __._Distance Trom foundation_-/ ------------Distance to nearest lot line Q27� ----- Number of lines---------- ------ ____Length of each line_ ' i�----------- g .��---------------------Width of trencha�-�---------------- ---- Type of filter materiaCk��(' '__Depth of filter material--/f-si---__-__Total length----------------- --------------------- .Seepage Pit: Distance to nearest welljoa) r Distance from foundation_ __.________.Distance to nearest lot line_ _�-_____- ®/ Number of pits......_- -----Lining materials � Size. DiameterCo^- 6r ;pepth_. Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material----___-.-------_.--.-______---..---. ❑ Size: Diameter----- --------------------------------Depth----------- j-------------------------------------Li Liquid Capacity q ------------------ - - -----gals. Privy: Distance from nearest well----------------___------------------------------Distance from nearest building____._..-----.-.--__---______..__._._.._.. ❑ Distance to nearest lot line----- -- ------------- Remodeling -----------Remodeling and/or repairing ---------/-_----r/� T-_-,r/�/.-- 1Q---------- -------.0�4/--- _4 --------0._._'Rx/i_"jAK-17------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------- =------------------------------------------------------------------------------------------------------------ ------------•------------------------------ ------------------------------------- ------------------=-----------------------------------------------------------------------------------------------------------------------------•---------- ----------------------- 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 re ulations of the San Joaquin Local Health District. (Signed( '; L - r� jjj/-------------------- ------. .(Owner and/or � �. - .� _ -..+am u' •-,r�...W+--•�rr �✓ -v wir 1... _ _ r-.� � :._y747- EY:----------------------------------------------------------------------------------------------- - ---- --------------------------(Title)_ !r/-s s---------- ---- (Plot plan, showing size of lot, location of system in relation to wells,,.buildings, etc.,'can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-------- ------------ ------------------------------------------- DATE----------`�'," ?4 ---------------------- REVIEWEDBY------------------------------------ -------- ------------------------------------------------------ ------------------ DATE BUILDINGPERMIT ISSUED------------- ---------------------------------------------------------------------------------------- DATE----------------------------------------------------- Alterations and/or recommendations--------------------------- I------ ------------------------------------------------------------------------------------ --------------- ----------- --------•---------------------------------------- -- --------- ---------------------------------------------I-------------------------------------------------------- -------------••------- -- I ------------------------------------------------------- - - - --------------------- ---- ----------- - --------------------- -------------------- ----------------- 4 -- --- ------ --------- ---- - ---- -------- -- --- - ------------------------------- -------------------- - ----- --------------------- ------ -- -- FINAL INSP CCTiQW_BY-� .��`---� ------------- Date------------ ----;L—ZO SAN JOAQUIN LOCAL HEALTH DISTRICT ; 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th street i Stockton,California Lodi,California Manteca,California Tracy,California F.P.Co.