Laserfiche WebLink
t <br /> r•OR OFFICE USE: FOR OFFICE USE: <br /> APPLICAEIr1N FOR SANITATION PERMIT Permit No.78-307 <br /> " -' ................. . - (Complete In Triplicate) <br /> ................................. . Date Issued <br /> This Permit Expires 1 Year From Date Issued <br /> Application is hereby made to the San Joaquin Loco] Health District for a permit to construct and install the work herein described. <br /> This application is mode in compliancewith <br /> 1with County Ordinance <br /> No.549 and e• -,ng Rules and Regulallonst <br /> JOB ADDRESS/LOCATION ! 'WV-*e4rd ^4J"' . 0 CENSUS TRACT <br /> Owner's Nome �� O•fJ � PhAPP7ZO-Oyd <br /> C <br /> Address.. . t!� 0 c___G.c� iI City S / - Zip .. <br /> Contractor's Name ��24 �P pts License #.ZSy;(t; Phone �.66 �.g6�•% <br /> Installation will serve: Residence'( Apartment House 0 Commercial 0 Trailer Court ❑ <br /> MotelO Other -' <br /> Number of living units: Number of bedrooms ZiC'arbage Grinder Lot Size <br /> PH <br /> Water Supply: Public System and name .. vate <br /> Character of soil to a depth of 9 feet: Sand 0 Silt 0 Clay 0 Peat 0 Sandy Loam Clay loam P <br /> Hardpan 0 Adobe 0 Fill Material If yes, type <br /> (Plot plan, showing sire of lot, location of system In ralutlon to wells,buildings,etc.must be placed on reverse side.) <br /> NEW INSTALLATION% (No septic tank or seepage pit permitted if public tower available wilhir 400 feet,) U <br /> PACKAGE TREATMENT I I SEPTIC TANK -}Sixe. .S �•• - Liquid Uept4 ' <br /> capacity 17-44 Type..+D+► Material Cil) i No. Compartments 7! ... .... <br /> s <br /> Distance to nearest. Well .. .. ......5V.................. .Foundation 4/0 �. . . Prop. Una � _ .... .. . <br /> LEACHING LINE (� No. o` lines Z/.. length ril e_op4h line . q0 r Total lengta <br /> 'D' Box Type Filter Material..( Depth Filter Materfai l '..op _... ..� _. .... <br /> /Q ,t ... .Prop" S. ... . .. <br /> Distance to nearest,Well ... ..✓�. . Foundation Lina <br /> SEEPAGE PIT I I Depth I Diameter . . <br /> ... Number .. .. .. . Rock Filled Yes 0 No <br /> Water Table Depth. ........... ... . ..... ..... . ._.. Rock Size- . .__ ... .......... ................... <br /> Distance to neoresh Well Foundation Prop, Line <br /> REPAIR/ADDITION (Prey. Sanitation Permit I. Date <br /> .......... .... ..... . . <br /> Septic Tank (Specify Requirements) '". . ...... <br /> Disposal Field (Specify Requirements) - - <br /> ;Draw existing and required addition on reverse side) <br /> I hereby coriify that I have prepared this application and that the work will be done in accordance with Son Joaluln Ceunry <br /> Ordinances, state Laws, and Rules and Regulations of the San Joaquin local Health District. memo owner or licensed agents <br /> signature certtfies the following: <br /> "i certify that in the performance of the work for which this permit Is Issued, I shall not employ any person Ie such manner as <br /> to become subject to Workman's Compensation laws of mlifemia." <br /> Signed 6� Owner r <br /> By Tide <br /> f Ther than owner) <br /> FORPARTMENT USE ONLY <br /> - 7--- /"TI-rM' -�y�p//----DATE •6 -° - ` --'- <br /> APPLICATION AC::EPTED BY J��+-• DATE <br /> DIVISION OF LAND NUMBER <br /> ADDITIONAL COMMENTS EXHIBIT B 1 Of 2 <br /> -- 0.-.� 5 Dote 45 •17 <br /> Final Inspection byi - �'j/ ru crier, ry me t• <br /> .., ine nnist trvnl NFAITH DISTRIrT <br />