Laserfiche WebLink
' APPLICATION FOR SANITATION PERMIT Permit No - ' <br /> (Complete in Omn�m�\ <br /> ` ' Dufo |our6 _..��;'� <br /> K - <br /> h�' o Son Joaquin Local Ho*�h Dist �� u permit foonno�uot and install 6on�n described. <br /> r <br /> TZi �'-- —ion is hereby ---- - - . ^ <br /> application ismade |ncompliance with County Ordinance No 549 <br /> JOB ADDRESS AND LOCATION------- <br /> ------'--'--'-- <br /> ~_.,~. , .,~,~^ -.-- .-- Phone__-_____ <br /> _ _ . -- --------------------------------------------------------- ---------------------------------------------- <br /> Contractor's N � <br /> Name --��__ <br /> Installation will serve: Residence QLApartment House [] Commercial [] Trailer Court [] Motel [] Other 0 <br /> Number of living units: /�-. Number ofbedrooms ';:�r1�um6or of baths - -.. Lot size -��^�--�� �u�-�------ ------ --__ <br /> Water Supply: Public system Community system E] Private 0 Depth to Wafer Table+ 2R ff. <br /> Character of sail to a�'depfh of � feet Sand [] Gn,vo| [] Sandy Loam [] Clay.Loam [] Clay [] Adobe 2L.,Hu,6omn [� <br /> Previous Application Made: Yes E] NoZ�_ New Construction. Yes R No �] <br /> , <br /> TYPE OF INSTALLATION AND SPECIFICATIONS- <br /> (No septic tank or cesspool permitted if public seweri» available within 200 feet.) <br /> .epf/o Tank: Distance from nearest well. io+*nca from 6zun6ofion'/m---.--k4u+v,ioL-<�..��. ___ v <br /> No. nfn,mpm,tnnnts.,.��_----..Size-����. �qui� 6oA+k'�-Aa_'f.x--------Capacity--'��io-v-' | <br /> Disposal Field: Disfancofrom`nearest well- M>24f-Disfance from foundation/--- <br /> 40 ^------Distance to nearest lot line---- l( <br /> ~_- <br /> Length of each koa_- of 'c6 -Num6or of |ino�.__� ��e _ ~� -------------- <br /> Type <br /> - <br /> ---- <br /> Tvpe cf �H.er � 'Deo+ of filter moto6ui'-/I'''-Jo+o| length ------------------------- <br /> Seepage <br /> -'-'--_- <br /> � <br /> Soeooga Pit Distance to | A_/*->^�B -*�u� . Distance <br /> I� Num6er c� p|6-'�,�----/ mo+:,io|���M���^ww��n: Diometoc.-��.37.��. Depth--°����~�.`-- <br /> Cesspool: r Distance from ne*ro,+we|L----.-Distance from foundation------------------ Lining motnrioL.---.,----.____ <br /> [] Size: Diameter ----.---------�Dept ------------------ --------------------------------- Capacity----------------------------gals. 'n^ <br /> � . <br /> PrD�f nce from n�u�, w°U---_-,-''-_'--'-.-Distance from nearest building---------------------------------------_ ' <br /> E] Distance to nearest lot line------- ----------------- -------------- ------------ -____.___.______________. <br /> Ramodaing and/or repairing (describe):-- -� <br /> --'---'--'-'-------------------------'-------''-----^-----'-''-------------'--'----------'--- <br /> ' <br /> --'---'---'--'-'--''-----''--'--'--'''-''---'------'-------------'------------------- <br /> '-----'----'--'---------'---''--'--''----''''-------'--'''--''------'--'-----'--'''-''---'-'-'- <br /> | that I have prepared this application that the work will be done in accordance with San Joaquin County <br /> ordinances, State I <br /> J�and rules and regulations of the San Joaquin Local Health District. <br /> (Plot plan, showing size of lot. location of systemin relation to wells, buildings. etc.. can be placed on reverse side). <br /> FORDEPARTMENT USE ONLY � <br /> ---------------------- <br /> -------------------------------------------­_----------------- --------------- .........W------- ---------------------L <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> oo South American ytr°°+ 30D West Oak Streot /mz s'"°="= Street 814 North "C" Street <br /> Stockton, California Lma|. o"|a°rri/* Manteca, California Tracy, California <br /> "°-3-2M ~54°°`=" . ,"° <br />