11632 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No. 7� {Complete in Duplicate} ��> This Permit Expires 1 Year From Date Issued Date Issued .__ ___�_u!__.___ 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---------- Nassano_ e,..__Nori h__off. 3._ ,dr—t-h-_Lane__-Qn-_we_st___.side_____ Owner's Name------D. C . Renfro & Son n . Contr. --- --------------------------------------A --- ------------------ --------------------------------------------- Phone----jaR.7----�. . .. Address------------------5023 Ashley Lane Contractor's Name------�'-he---D1�;---&--NICHT--S!'-pUQ---Tank---Sex'Y1.02--------------------------- ------ Phone-------HO 2-rtTQ.4 Installation will serve: Residence [3XApartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: __ar___ Number of bedrooms __3___ Number of'baths ---lz'Lot size -----------135-1-- X 160 1 ------ r-_--_---_ Water Supply: Public system E] Community system [:] private {Depth to Water Table _�'a- ft. i Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam& Clay ❑ Adobe M Hardpan ❑ Previous Application Made: Yes [❑ No K3 New Construction: Yes [4 No ❑ FHA/VA: Yes ❑ No ❑ 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 prom fj ndation____ 0_ ___.__.Ma#erial__ C---BT'�C-t-_-------------------- Size____________________ Liquid de th_ "_.._ 2 No. of 6-- ---- �6 X �.� q R -------------Capacity-- 1.200 G Disposal Field: Distance fromrnear nearest well._.---_'___.....Distance from foundation___- 0-M------.Distance to nearest to me------5__..... . Number of lines_______2_________________________Length of each line-___-7.�__-_ _.Width of +rench.._-__2�________--------------- Type of filter materialae-p_e---RoC_kDepth of filter material____- -__Total length----------------1 5P --------------- Seepage Pit: Distance to nearest well---1-00.1--------Distance from foundation____g5_i.......Distance to nearest lot line___s_1._______ Number of pits-----9-------------Lining material----ROCk.------Size: Diameter-_ ----------------Depth-------------25___----------- Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material------------------------------------- Size: ____--------_--__-- .---__Size: Diameter--------------------------- Depth-----------.---------------- -----------------------Liquid Capacity----------------------------gals. Privy: Distance from nearest well------------------------------------------------- from nearest building----------.-_--_________________________- ❑ Distance to nearest lot line- ------------------------------------------------------------------------------------------------------------------------------------------- Remodeling and/or repairing (describe):---------------------- --------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -----------------------------------------------------------------------•----------------------------------------------------------- -- ------- ---------- ------- ---- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State law=d rules and regulations of the San Joaquin Local Health District. J {�Contractor) (Signed) ------ -------------------------------------------------- EPTICTANK SERVICEByX9 -E:lWinerAvg:;THO:�7f)4-&-------------------------------------------'------------------------------------- ( )--------- ---------- ------------------------ ----------------- (Plot ----- ---------(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 1 i REVIEWED BY--------------------------------------------------------------------------- ------ DATE----------------------------------------------- ------------ BUI LDI NG PERMIT ISSUED-------------------------------=-------------------------------------------------------------------- DATE------------------------------------------------------------ Altera+ions and/or recommendations----------------------_ --------_ _ ._ ----------/------ ------------- ----------------------------------------------------------------- ------------------------------------- ----------------------------------------------------------------------------- ----------------------------- ------------------------------------------------------------------------------------------------------------------- FINAL INSP ION -- --------- Date--- SAN'JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California Es-9-2M Revised 8-'59 F.P.Co. '�