833 - Laserfiche WebLink

Home Browse Search

33 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 ap lication is made in compliance with County Ordinance No. 549. ` f 74 & s CZ-2, s 1O� Glenn Rd JOB ADDRESS AND LOCATION-----Gray__flat---top---on__north__west___ _orner___Qf__S_ ' ---Road--- ____________ in Swain6-gins Owner's Name Q!?Ze111 1jr_QS] r�o•----- ----------- --------------------------------- Phone---------9957-1-------------- Address--------9 91-14=t45Q_ ad:4 Contractor's Name----�,------ 10-------a0a4--INC-•---------•-------- _-------------•---------- Phone-----9..960-7----------- Installation will serve: 'Residence K] Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: -M Number of bedrooms ® Number of baths ❑ Lot size--------601-x.1Qt-------------------------------- Water Supply: Public system ❑ Community system X Private ❑ Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobes] Hardpan r r 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-- MEL--_Distance from foundation--------100,---.Material--- e-_BrIck---------------- - xx P 2 Capacity Q--- iz 56e.-x36! 63" Liquid depth----5Z..-------- ' No. of compartments _Ca acit g0� Cfi' e r,. Cesspool: Distance from nearest well_________________Distance from foundation------------------- Lining material-------------------------------- Size: _------____----___-_--___----Size: Diameter--------------------------------------Depth---------------------------------------------------- :Privy: Distance from nearest,well-------------------------------------------------Distance from nearest building------------------------------------- F1 Distance to nearest lot line------------------------------------------------ Seepage Pit: Distance to nearest well----------------------Distance from foundation--------------------Distance to nearest lot line-_-__---_--_-_ ❑ Number of pits----------------------Lining material-----------------------Size: Diame=er------------------------Depth-------------------------_>E-_l1 :kVA Disposal Field: Distance from nearest well__-_N-01le-.Distance from foundation-----24---------Distance to nearest lot line___--_5---__ l Number of lines__-__---_-_ � �.---��------------Length of each line---SQ---.��--3��---.Width of trench------2--------------------- Type of filter material_--�.-z_-_---Rk-__-Depth of filter material----____-_-18_--_- Remodeling and/or repairing (describe) Ne-W --ina-ta .lation---------=--------------------------------•------------------------------------------------ ------------------ - -..._ --------------------------------------------------------------------•---------------------•-----------------------------------------------------•-----------------------------------------------------........ ------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 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. (Signed) A zc`' SONS-� INC. ------------•---------------------'--------------------- Contractor) r�. $Y----------- -- .------------------ --''----------�-- ------ ---- --- ------ --�--------------------------------------(Title)-----�'i.S_�llCl&t Qr----------------------------- - (Plot plans, show size of lot, location of sys min relation to wells, buildings, etc., must be filed with this application). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BYV ------------ ---------------------------------------- DATE------t ----------------- ----- � ^ -- REVIEWEDBY------------------------------------------------ ----------- --------------- ------------------------------------------ DATE--------------------------------------------------------- BUILDING PERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE------------------------------ Alterations and/or recommendations------------- ---------------------------------------------------------------------------------------------•-----------••-•------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------------------------•--------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------•----------------------------------------------------------------- ----------------------------•--•---•------------------------------------------------------------------------•---------------------------------------------------------------- ----------------------------------------- PERMIT No---- -.3 -------- ISSUED------- _- -Z-_-- --1__------(Date} FINAL INSPECTION BY--------------- ' --------------------------- Date--------------------- - --------------------------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California ES-9-2M 9.50 W-1639