SU0008802 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: = APPLICATION FOR SANITATION PERMIT I -----.-,-...•.••_._._ (Complete in Triplicate) Permit No. 7.Tc'.5 - -. ---------------•...........•......•----------------------- This Permit Expires i Year From Date issued Date Issued 4-11.7_-.:Z?,- Application x-.1..7= ?:-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 mdde in compliance with County Ordinance No. 549 and existing Rules and Regulatlons: f it JOB ADDRESS/LOCATION ...... -- --•M.4J :jJ�t/.--•_� ----• �` !- .. .... ......... TRACT .�� �* . ........... ....... }' Owner's Name _ .LZ .-..J. -?R►4- -----------••------................... J �- Address .v��..� oS � � •--�---..—.....Phone f��...... f`3�1 .11V ................City _/ ..'91 t1!!.{ et Contractor's Name � .;_ .. /...�`tQ-------------------------License �"�c3/�/� ............f i -- ----- Phone ....:........�'.:5 ' Installation will serve: Residence (RApartment House,] Commercial 0Tr6iler Court 0 f e Motel ❑Other........:1.............. Number ofliving units:--.---/- Number of bedrooms ?_...Garbage Grinder ............ Lot Size -..� Water Supply: Public System and name ------------------------------------I --------------------- ------------------------Private El {{ Character of.soiI tb a depth of 3 feet: :. Sand K Silt fl _.: :Clay [3•.. Peat[] ..Sandy Loam fl Clay Loam,].,.�__ _- Hardpan Ej Adobe 0 Fill Material ------------ If yes,type............... �! [Plot plan, showing size of lot, location of system in,Teldtion to wells, buildings, etc. must be placed on reverse side) NEW INSTALLATION: [No septic tank orseepa pit permitted if public sewer is available within 200 feet PACKAGE TREATMENT { ? SEPTIC TANK Size:. ----- Liquid Depth ! Ca acs •-.'_`, � p ty' ./..'L�rf... Type ._....... Material-. No. Compartments ........ ! . •.. j istance to nearhst: Weil ---------cSr�------_-- / C�• ------ --Foundi5tion .._..._-......._. .... Prop. Lina ........... LEACHING _ LEACHING LINE iVa- of Lines �� ° ;5...... each Cin 7 " J E --- ------------ ---------- Total-Length .�� .........._:: �. D: Box ._`_._...._ Type Filter Material ....�__._,. 'DepthFilter Material .... . ri ` ............................. Distance to ne rest: We ------6 _------- Foundation -__ Pro arty Line �.a......_... /....... SEEPAGE PIT { Depth -=-•--.. ..---- Diameter ---------------- Number ---...----- A•...---•••--- Roc Filled Yes • No N Water Table D pth --- ---------------•...... _.Rock Size ....------_-,---- Distance to ne st: Well -....._._-_-. Foundation --....... Prop. Line ..-----•---- REPAiR/ADDITION(Prev. Sanitationi Pe i _,,,,.- ,•-_______ "" Date ................... _ Septic Tank (Specify Requirements) .- Disposal Field (Specify Requirements) ' L.... •----- / L.�t..!_ll�r -..._....--- X11`1 E;------••----------------------- --- - -- • - - . - i(Drawexisting and required addition on reverse side) " ------- I hereby certify that I have prepared this application and that the work will be done In accordance with San Joaquin f # County Ordinances, St ate• Laws, ani! Rules and Regulations of the San Joaquin Local Health District. Nome owner or licen- 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 ire such manner as to become subject Workma Compensation laws of California.,, Signed --- - -- ------- Owner By ..._..-. r title -....... i [!f other than owner) ......... --------•----------•---•••--•---- i {� FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY..-. =-T1_r.�------------ -••---•-•-.............----• --------...... -- BUILDING PERMIT ISSUED -----------_•-{ -P - DATE•- -. `/�".� .... •• ' ----- -------DATE _........._. .. ...... ADDITIONAL COMMENTS .._ - ................_...-•---- . •---------- -------- ----------------------- ._ ---•- ................................................ ------ ----- ............... ..--••--- ........................... Final inspects i -- - - -.-..,-.......;........-_...Date ' SAN JOAQUIN LOCAL HEALTH DISTRICT E• H. 9 1-'68 Rev. 5M s