4338 - Laserfiche WebLink

Home Browse Search

5f+r'PL1CATiON FOR SANITATION FcnivllT Permit No. �-- p = (Complete in Duplicate) S3 Date Issued V Ap�,l a+ion is hereby made to the San Joaquin Local Health District fora ermit to construct an i p d install the work herein described. .This application is made in compliance with County Ordinance No. 549. i 1 I JOB ADDRESS AND LOCATION-___ Owner's Name------------ ------ Ph /-.--- Addressr ------------------------ ----------------------------- . T -----------•----•-••------------- ........ Contractor s Name ------ _ -----------------•-------------------------------•----- Phone_: Installation will serve: Residence ❑ Apartmen+.House ❑ Commercial X Trailer Court ❑ Motel ❑ Other ❑ ; Number of living units:Id_ Number of bedrooms/ . Number of baths/Q Lot size ___ Water Supply: Public system ❑ Community system ❑ Privatex Depth to Water Table.33_- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ ' Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe�f' Hardpan ❑ Previous Application Made: Yes ❑ No `t" New Construction: YesIZ No ❑ T 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----1_Q._......Material--- fNo. of compartments---._..4.._. s+6 i� 7� -_.---LiquidCapacity_Size Dist from Distance from DisY.. posal Field: INumaberoi linesearest well- ------------- Length of each line foundation___----------_---._:Widthcoftfrench nearest lot line ---------------------- --_MOS Type of filter material-________________________Depth of filter material--------.--------------Total length-------------------_.--.-------------------JD- Seepage - m - Seepage Pit:' Distance to nearest well------ _-Q_.___-_ Distancenfrom f�o�urdation___ .._____.Distance to nearest lot line____-.�__ Number of pits--------9----------Lining material-4..-- __ Size: Diameter.--,�/------:--- Depth------ac�------------------ Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material-_ ' -_ ._________-,_ _-• ❑ Size: Diameter------ ----------- -------------------Depth----------------------------------------------------Liquid Capacity----------------------------gals. Privy: Distance from nearest yrell-------------------------------------------------Distance from nearest building-------------------------------------- - ❑ _ Distance to nearest lot line------------------------------------------- Remodeling and/or repairing (describe):-.-.-S- - - - -------------' ¢_e?.lr... _ 5 _ ----•-------- ------- -- f 'R -U.... �/ �(�l�c '� ------------------------ ---------- --- -------- ---------------- -------------------------------- I ' • ' , . ---- -- . --------- ----------------------------------------•-------------------------------------------------------------- ordinances. -------------- '=- �h I hereby certify that I have prepared this application and that the.work will be done in accordance w4h San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. _ _ _ _ (Signed) - - {Owner and/or Cantractorj ------- - --- - -- -- - ` �Y� eE'. -- ----------------••------------- -----(Title) ------ (Plot plan, showing size of lot, location of sys m in relation to wells, buildings, etc., can be placed on reverse side): , FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY--.-- ----------------------------- Y --•------------------------- DATE.------ - r -- ------ -- -------------- REVIEWEDBY---------------------''==---------------------------------------------------------------------------------------------------- DATE --- a BUILDING PERMIT ISSUED ----------------- DATE = ' Alterations and/or recommendations:-------------------------------------------------------------- ----------------•--------------- -------------•--- ---------------- ------------------------------ -------------------------------------------------------- -.. -------------•--------------- -----------•--------- ' ` ------------------------------------ FINAL INSPECTION BY:..:.-----•-- ( I !g f _ _ [ - ------ Date-------- --k----- SAN JOAQUIN LOCAL HEALTH DISTRICT h 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street 4: Stockton, California Lodi, California Manteca, California Tracy, California is ES-4-2M I0-52 Revised W-2100