SU0007346 SSNL - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT -- . _.... - -- -- (Complete in Triplicate) Permit No. -:7-...7--�l..y.-. -----------............................... .............. . ......................................................... This Permit Expires 1 Year From Date Issued Date Issued 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 �and existing Rules and Regulations: JOB ADDRESS/LOCATION _ -�j6-----,+Lev.__LtIFt�Y�l�I�sJS- .� _...L/�' �YFfIL. .? US TRACT ......... ................ Owner's Name . e�1-I✓ -_L.�//��4i /h� ..... Pho _. ... ......-........... - Address *6 e'—L Contractor's Name . % .Fl -_.+�Fltlf'! _ PYG'.:...-------License # Phone `y��,ltaJtl1. Installation will serve: Residence ❑Apartment Housoo Commercial❑Trailer Court 0 Motel E]Other .---Ria.$vrc' -- -r--.--.--. Number of living units:...--------- Number of bedrooms ............Garbage Grinder ............ Lot Size .. .........................•-•••-- Water Supply: Public System and name ........ --•----.................................-...._......................•............................Prtvafu Character of sail to a depth of 3 feet: Sand Silt❑ Clay ❑ Peat❑ Sandy Loam 0 Clay Loam ❑ Hardpan ❑ Adobe O Fill Material ............ If yes, type ............... ........ .... (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side.) NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) j PACKAGE TREATMENT ( ] SEPTIC TANK SizeX1Q................... Liquid Depth .....4................ Capacity Type Material.COW...---.--.. No. Compartments �r ....... r Distance to nearest: Well -----/ D.....................Foundation ...... Prop. Line ....`�'—... f r LEACHING LINE No. of Lines .-....I............... Length of each line---- .......... Total Length ....-7Q.............. /\ 'D' Box ... l .. Type Filter Material /...L)�. --�-Depth Filter Material ....../..� ......................... Distance to nearest: Well _A�W......f....... Foundation .../90---r.......... Property Lina .......... SEEPAGE PIT [ J Depth ....__.._...--._- Diameter ................ Number ......... ..............._. Rock Filled Yes ❑ No ❑ f Water Table Depth ...---•--- ------•--------------------------Rock Size ....-........................ Distance to nearest: Well ......-.................................Foundation -.----..------....-- Prop. Lina ...................... REPAIR/ADDITION(Prev. Sanitation Permit# ............................................ Date ........................-.--......) %I SepticTank (Specify Requirements) ................... ................--......................... ........... ---•................................................. - Disposal Field (Specify Requirements) -..................................-.......... ........................ ................................. ------------ (e ---.....--- ------------------------------------------ -------------------------- ----------------- - --- ----------------------- •- -----.....-------- ------------•---_.... --.-----....--•------•-•----.....-. (Draw existing and required addition on reverse side) 1 hereby certify that I have prepared this application and that the work will be dons In accordance with San Joaquin County Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local Health District. Home owner or licew sed agents signature certifies the following: "I certify that in the performance of the work for which this permit Is issued, I shall not employ any person in such manner as to beco subject to Workmon'4s�pensa--tgiio''n l�aws of California." Signed --- Com ` -G .------------------------ Owner By - ... - - ........... -------------------- Title - e - - (If her an owner) .._..... FOjt OPARTM T USE ONLY APPLICATION ACCEPTED B --------- DATE BUILDING PERMIT ISSUED ._.---------..-. ------- --- --- ATE __.-----.......--.. ..----- ADDITION L COMMENT �-cdsv7v..*�ea...... s r .lam _- - .. - +c .jsse . --------�.-r> �_.....------------ --- --.............--.........._....._....--........___-------- -------------------- ------------- ---..--_ -- --- ------`--------------- - ... -- ...__ ------ . - - ... .... ,Q FinalInspection by: ......._.. f.,•._...._.-._..---------------._..._....----....---...- ---......_._--- ----....Date _.f-1 .., -- . ..7. .._..- 13 24 1-6f3 lieu, 5T1 SAN JOAQUIN LOCAL HEALTH DISTRICT 8/711 3M