Laserfiche WebLink
APPLICATION FOR SANITATION PERMIT Permit No. -1 . ........... <br /> m �n Omnkcafm <br /> (Complete— ---' Date Issued <br /> Application is hereby made to <br /> ' a San Joaquin Local Health Dist rid for it to construct and install the work herein described. <br /> i nty Ordinance No. 549. <br /> JOB ADDRESS AND LOXCA PN/----- --- ---------------- e_ <br /> Installation will serve: 1 Residence Apartment H se mmercial El Traillir C urt [j Motel Ej Other L] <br /> ths <br /> Wafer Supply: Public' system [-] Commurfify system [:] Private P' Depth to Water Table<r(-)- ft. xo_"� )0_4 <br /> Character of soil to a depth of 3 feet: Sand E] Gravel LK Sandy Loam x Clay Loam [] Clay E] Adobe Hardpan <br /> Previous Application Made: Yes [-] No P� New (�c'nsfruction: Yes 1� No 0 FHA/VA.. Yes No E] <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or'cesspool perm4fed if public sewer is available within 200 feet.) <br /> pkic,i Tank: Distance from nearest well-._1 --------- --- <br /> Disposal Field: Disfance from nearest well--- Di'sfance from foundation---1­0-------- Distance to nearest lot h <br /> Type of filter maferial_____$_T.J1r_ I I -Total length--------- --- <br /> LJ Number of p/m---.—.�—unmg mo�eno|-------�u/=a- u/�m�te,-----._unFth-----_-_.- i <br /> ' ' ~ ' | <br /> El <br /> e: Diameter <br />-- ^ - ' ` - <br /> Privy; Distance from nearest well: :'—'Distance from nearest building''''-'''''-'_--'-'- i <br /> [-1 ` ' Distance to nearest |o+ |ine.-.-��-+—�-�-._-_-------___.--'-_--_-.��c---..'-_------ <br /> - ` <br /> . . <br /> ' Remodeling and/or rep*Gmg (describe):--------------------- ------------------------------------------------------ ------------------- \` | <br /> ' -_.___'--___.--._.---.-__.----'-_--_�._-____---___-..__-_-_--._-_---.___---_-'_—. <br /> ` <br /> -_..�-_-_---'-__.'-----'_-_-'-�_.--'-__-''-__--'_____.---__-_-__------._--_--_-_-.—..__.--- <br /> ._--__—'-------- --------—----------'''-----------''--------------------''----------------------------''-----.--'''---_--__.____-._-----. <br /> I hereby certify-that I have prepared this application and that the work will be done in accordance with-San Joaquin County <br /> ordinances, Stafe.laws, and rules an, re -of the San Joaquin Local Health District. <br /> (Signed)---------------- -------_--._--'_._--..-(wwnwrand/or Contractor) <br /> �`_-'�-__.''''--_--'--_''--_''_--'''--''-_-''''_- ."m)-'_-.' _'''--=-...'�-------------------- <br /> 7 - <br /> (Plot plan. *ize of lot. location of system in relation to weUs, bd|d/ngs, etc.. can be placed on reverse side). <br /> \ ' <br /> FOR DEPARTMENT USE ONLY , <br /> APPLICATION ACCEPTED 8Y_ DATE. <br /> REY|Ey/ED BY------------------------------------- ---------- -.---- DATE <br /> �� � ---_---- - �!-f�-=-�-�'-�{_ <br /> ._�-����.� <br /> �BU|LD|NG PERMIT |SSUED-'_-'.----_-- ` ���� . D�TE --­.- <br /> Alterations <br /> Ntera6onsmnd/ur recommendm�ons:---.--------------'-----------.-.----_--.---.---_.-----�-�_r_�—_~_—__'_—' <br /> '_-_--_-_-_-.--'---_---_---_--------_'-_----.__.._--_-.__-'-_-.--_-----__'__-_.— <br /> --------'------------------'--^--~^--'-------'----'-----'------^-------------- <br /> -_��---__------------'_ <br /> _--_---____-----___���_-------_---__---__---------________-----------__-------_---_---_---___-----__----_---_r�___---_---_--___------_ <br /> -'--''-''-''' ---��''-�''' ----------------------------------------------'''''--''-''---'�-------- '''' ----------------------------- <br /> � RN/ L |NSPEITkO JDate-.'--- -- / <br /> 7'___'_ - - � SA4 <br /> J[�AX�U|N L<��ALH��LTH DISTRICT ' <br /> /30 South American Street 300 West Oak Street oz Sycamore Street o/* North "C" Street <br /> ^ <br /> Stockton, California Lodi, California Manteca, California Tracy, California ^~ <br />