2001 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT (Complete in Duplicate) Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. > This applicafion,is made.in.compkance with County Ordinance No. 549. 171- i 72--02 JOB ADDRESS AND LOCATION---Rts--- --BOX--644--St-o-cktonT--Hi_May--9--Southl--next- l ------ Owner's _Owner's Name-----...__-OB :- _ E tebS1 --------- Phone-----------NOM--------------- 33�' Address------------------------------------------------- ------------------------------------------------------------------------------------- ------------------------------------------------------------ Contractor's Name---------------- -----------Il�__A.--PARRISH__8c__SDN"a�---INC_----- ----------------------------------- ------ Phone------- 9-9607-------- --- Installation will serve: Residence [X Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: -M Number of bedrooms Ej Number of baths Ej Lot size____ _kiT_Q„"'______________________________________ Wafer Supply: Public system ❑ Community system ❑ Private 11 Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam❑ Clay ❑ Adobe IM' Hardpan ❑ , a 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________________Distance from foundation-------------------.Material__-_____--------_________________ -k, ❑ No. of compartments--------------------------Capacity-----------------------Size--------------------------------Liquid depth--------------------------. Cesspool: Distance from nearest well-----------------Distance from foundation------------- ------Lining material----------,------------------------__ ❑ Size: Diameter---------------- ----------Depth----------------------------------------------------. I Privy: Distance from nearest well___________________________________ _______._Distance from nearest building-_____._____-______------ ❑ Distance to nearest lot line------------------------------------------------- Seepage ________________________ ____Seepage Pit: Distance to nearest well________PP— Distance from foundation------30_ Distance to nearest lot line------'5W_-_- EX Number of pits------I-------------Lining material-------P_G--!�;' : Diameter-------.33!---------Depth----------201---------------� Disposal Field: Distance from nearest well------------------Distance from.-foundation---------------------Distance to nearest lot line------------- ❑ Number°of lines________________________------._-_Length of each line------------------------------Width of trench----------------------------------- Type of filter material-------------------------Depth of filter material____`-____. `_____"� � Remodeling and/or repairing (describe)-----------------� pP e31 ,E1T -Uk'&i3T18g ---------------•-_'=---- -----------------------------__-------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ -------------------------------------- - ---------------------------------------------------- --------- -------.------------------------------------------------.----------- --------=---------------------------------------- --------- - - -- - - ------ --- 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. I (Signed) _ ' SR_&__SOP18 �1T -----�--------------•--------------------•--------------------------( .Contractor) 9 ) r By:----------- Title Si3mator Jf (Plot plans, showin ize of lot, location of syst in relation to wells, buildings, etc., must be filed with this application). TTTT a FOR DEPARTMENT USE ONLY I APPLICATIONACCEPTED BY---------- ------- - ----- ---- ----------- -------------------------------------------- DATE------------------------------------------------------------ REVIEWEDBY--------------------- ---------- -- -- -- -- --------------------- -------------------------- DATE--_ / ._ y— 6=7------------ BUILDINGPERMIT ISSUED------ --------------------- ------------------------------------------------------------------ DATE------------------------------------------------------------- Alterations and/or recommendations______________________ ___ ------------------ -------- ---- ---- ------- ------------------------- -------------------- ---------------- --------------------------------- ------------- - ------------------- - - -------------------------- ---- ----------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------- ----------------------------------------------------------- PERMIT No-------- i--- ISSUED------------------------------ -----------(Date) FINAL INSPECTION BY: --r-- V Date-------------------- SAN -----------------,SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California E$-9-2M 9-50 W=1639