16232 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: ------------------------------------------------------- _ Ai .rLICATION FOR SANITATION PERn.,r Permit No. ._.—-------- ------------ -------------------- ------------------------------- ------------------- (Complete in Duplicate) Date Issued - . _-----------_--------------------------------- This Permit Expires t 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. JOB ADDRESS AND LOCATION........ w -n---Oak---Nobl-l-e--- ark----4a2-3----H Hi-Way T0d1-rCa1-i-f-w----------------------- Owner's Name------W.A,t-SanBeen-.-&-R. J_.Perat.a----- ------------------------------------- y 99, L ----------------------------- Phone------------------------------------ 4823 So.Hiwaodi,Calif. Address------------------ - - --- ------ •-------------------------------------------------------------------------------------------------------------- Contractor's Name----- t ------------------------------- Phone----------------------------------- Installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court [§ Motel ❑ Other ❑ Number of living units: .-6--- Number of bedrooms .------- Number of baths -------- Lot size -----/R�L -?-------------------- Water Supply: Public system ❑ Community system ❑ Private ® Depth to Water Table$751�- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ -Clay ® Adobe❑ Hardpan [� _ Previous Application Made: (If yes,date--------------------) No ❑ New Construction: Yes ❑ No ❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: . (No septic tank or cesspool permitted if public sewer is available within 200 feet.) [,!' t t w Septic Tank: Distance from nearest well-----_5Q----Distance from foundation-----_10------.Material-_CDYICTQt!2----------------------- _�fI t t - t 2400 ® No. of compartments--------3----------------Size_41_ --.X2a.---X5tLiquid depth-------4.--------------Capacity-__------------ga-- Disposal Field: Distance from nearest well-------5Q.T-Distance from foundation------ ]Q-t----Distance to nearest lot tline---5-=--- ® Number of lines--------2------------------------Length of each Line------aQQ.............-Width of trench-----`2_--:-------------------- Type of filter materialSeP_*_rPGk-Depth of filter material---11�-:- .-.------.Total lengfh__200------------------------------- Seepage Pit: Distance to nearest well .----1.0 t-_--Distance from foundation.--_Q--_---.Distance to nearest lot line---- .t------- .. 2-5-i----------------- ® Number of pits--..-----2---_-.------Lining material--------�'a-Ck -Size: Diameter....48........------Depth----- -- Cesspool: Distance from nearest well-----------------Distance from foundation_--.--------------Lining material------------------------------------- *j -------..----------.------.-------.-*f k ❑ Size: Diameter------------------------------- ------ Depth---------------------------------------------------Liquid Capacity-- -----------------------gas. Privy: Distance from nearest well-------------------------------------------------Distance from nearest building------_-.-_---.-------_----------------. ❑ Distance to nearest lot line---------- ---------------------------------- --------------------------------------------------------------------------------- ------------- 4 Remodelingand/or repairing (describe):----------------------------------- ---------------------------------------------------------------- --- ---------------------------------------------•-- ------------------------ ----------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------- ------ ------------------------------------------------------------------------------------------------------------------ •------------------------------------------- ------ ----------------------------- --- ------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 4, I hereby certify that I have prepared this application and +hat 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. (Signed)----- ---T, E -I-GE------------------------------------------------------------------------------ XXKd/or Contractor) --------Title (Plot plan, showing size of lot, location of system in relat to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY r APPLICATION ACCEPTED BY-----, -------------------------------------------------------- DATE---- --_' --G3------------------------------ REVIEWEDBY---------------------------------------------------------------------- -------- ------------------------------------------- DATE-------------------•--,----------------------------------- BUILDINGPERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE------------------------------------- ----- ----------------- Alterationsand/or recommendations------------------------------------- --------- -----------------------------------------------•-----------------•------------------------ -------------------- ------------------------------_-----------I-------.---------------------- --------------------- -------------------------------------------------------------------------------------------------------------------------- ----------------- -------------------------- -•- -----•------------------------------------------------------------------------------------------------------------------------------- ------------------------------------- ------------------ --- --------------------------------------------- ---------- ------------------------------------------------------- -------------------------------- ------------------------------------------------- - 00:111 -------------------------------- ------- ----- - FINALINSPECTION BY•- .-. .. .. .. --------------------- Date-- -��1, ------------------------------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 91h Street Stockton,California Lodi,California Manteca,California Tracy,California ES 4 REVISED 8-59 3M 3-'63 F.F.CG.