SU0005296_SSNL - Laserfiche WebLink

Home Browse Search

A,JCATION FOR SANITATION PERI. Permit No. . 11 )Complete in Duplicate) Date Issued a.=S.S-3 �. Application Is hereby made`•to the San Joaquin Local Health District for a permit to construct and install the work described. This application is made in compliance with County Ordinance No. 549. �7 ' �� North Rte 2 Box 550, Stockton; New St. Francis Motel, Hi Way 99 JOB ADDRESS AND LOCATION_................................... . -Mie & Mrse a Je Gooder 2-6226 Owner's Name............................... --------I---------------------- Phone................... .............. Address......................._.._._...._........._Same, , Next to State Hi Way Patrol Office. -----------•'•-••------------•-----...._ --------------•-•-----•---------•---------------------------------------•------•---•-••-----• . Contractor's Name......-_.................PRRISH INC.. 9«9607 ---.......------------.._...'----...............-..................-- ........... Phone---'----..................-..... installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel [4 Other ❑ **Number of living units: ------ Number of bedrooms W-_.._ Number of baths 4:.... Lot size ..2 Acres - Wafer Supply: Public system ❑ Community system ❑ Privatefyi. Depth to Water Table'J..5_-- ft. Character of sail to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe @C Hardpan ❑ ■. Previous Application Made: Yes ❑ No [I New Construction: Yes)j No ❑ Supplement to existing system TYPE OF INSTALLATION AND SPECIFICATIONS: )No septic tank or cesspool permitted if public sewer is available within 200 fee+.) CC Brick Septic Tank: Distance from nearest well_ -00 Distar� f m {�undation._10 t.........Material----------------------- `)"� X n . ECIIO. G 1 QC No. of compartments..3_._..._.............Size- a...d�e Liquid depth_�2.-.._....__..___Capauty......_....---------- 115: c p- '--- 25T 10� Disposal Field: Distance from near@st well.................Distance from foundetjgp.,.......__._....__.Distance to nearesQ4161ine..._............ Number of lines.__.__1....... Length of each line.....__.. Width of french.. 1 P.k_ Ygr- ------- 5�. Type of filter material......................._Depth of filter materrel...............____..__Total length..............----------......._.._..... f ? ! Seepage Pit: Distance to nearest well_._-S............Dlstan$$�� frq�n {oupdation._ •P._...-...... nce to nearest I t 1 e..._10 �] Number of pits_.... '.... ._.Lining materia.........r...0 Size: Diameter..__ ...... -----.Depth_.._ 4 --. -------'----'--... \ 1 Cesspool: Distance from nearest well.................Distance from foundation---------------------Lining material.............................. ❑ Size: Diameter----_-----------...................Depth_......—---------------------------------------Liquid Capacity.._------.............._...gals. � Privy: Distance from nearest well................................................ Distance from nearest building.......................... ❑ Distance to nearest lot line------------------------_.----------•-----...--------------------..---------------------------'-------------...._-----`.-. fs ** System to serve addition to present units. Remode' n r repairin describe :---. ._.. .. - --s'e1 --- �ng .... m se ving--preseri'C iAniCs. L -........_........... .--------------- --------------- ----- -------- --------------------------------- •------- •------------------------- ---- ---------------------- -- ------------ ............... - I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of +he San Joaquin Local Health District. L )Signed).............PARRISH INC.:_- -- --" -- -- ) f onfractor) ........ ' - ------- ----- ------------------------ Estimator By:----•-- ....._......-- - - ,_=- f d. -�-------------------(Title).------------------------ ---)Plot plan, showing size of lot, Iota 1 of system in relation to wells�ildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY ` APPLICATION ACCEPTED BY--- -------------------..._..__._- -------.....-----'----............ DATE�.............. ... --'----' -------------- L REVIEWED BY. - -- .. --- .... DATE il-------•------------------------------- ... -'----........-' --------------------------------------- BUILDING PERMIT ISSUED ' ----...... '--"--------..........'----- -.....•--- '-------------............. DATE....,.._ t.J`1-------------------------------------------- L - ' - LAlterations and/or recommendations:-----`----._......................... ---.' -'----• ----'............-......•-•---•-........-..............'..............................1---- ....................-------'•------_---------------- - ---....- ... -' - - FINAL INSPECTION BY:- - ....- : ' -- - 2� - - ' Date- T -- -`�f� - PLATE L --- , � -� s SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C Street fStockton, California Lodi, California Manteca, California Tracy, California L.. ES-9-2M 1052 Revised W-2100