SU0008620 - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE: f ---•----•••-----•---• ----------- --------- APPLICATION FOR SANITATION PERMIT � Permit No, '---------------------___.......------------.....__. (Complete in Duplicate) ................ ----------------------- .............. This Permit Ex ires 1 Year From Date IssuedDate Issued / r1 Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. '440 1'his application is made in compliance wit County Ordinance No. 549. �^•S _ (�3Q'(S JOB ADDRESS AN CA. ON.. ................ ----------•-- Owner's Name_ Pho e........................... '1 Address-----------------------••--- 2,A,6. � ... --- Contractors Name_..--- P [.±�ASL/ Phone.......................... ..-----•- d Installation will serve: Residence (�partment House ❑ Commercial ❑ Trailer Court ❑ Motel [] Other ❑ e Number of living units:/_... Number of bedrooms -jm:2-• Number of baths _9_ Lot size - •----..404.-. ; Water Supply: Public system ❑ Community system ❑ Private �epfh to Water Table _..V. ft. Character of soil to a depth of 3 feet: Sand ElGravel ❑ Sandy Loam [:] Clay Loam❑ Clay [1'�Atdobe❑ Hardpan❑ Previous Application Made: (If yes,date_________ __________I No ❑ New Construction: Yes No ❑ FHA/VA: Yes ❑ No❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) -1199 Septic T k: Distance from nearest well-.� •--_-Distance from foundation_. L?..�.._.Material._ No. of compartments . �s - _--- -Li Liquid de th_.._. P �' Size q +p ��.................Capacity_l�-47.40.- Disposal Field: Distance from nearest well-5Z..0._•..Distance from foundation__ �S -------Distance to nearest lot line... ._.._ Number of lines--..--•-------------•--••---......Length of each line. cr?..�__._--- -;----.Width of #rencha,_�,._...__-----•-_-•-•• .� Type of filter material�,- /�!...-Depth of filter material _--------Total length. ,_,�d..... ..... Seepage Pit: Distance to nearest well_-•-------------------Distance from foundation-..__---__.____.---Distance to nearest lot line........... ❑ Number of Pits------..--------------Lining material--- .................Size: Diameter-------------- -••---Depth_................_._.--------- 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.__._.._...-----•---------------- -----••-----••-------•-••--...---._..__. Remodeling and/or repairing (describe):........................... ---------------------------------------------.......-- -----•------------------------•--------....----------.-------...-------•-•-••-._-...----------------...... --•......------.-.------.......--•-----•--.......__......---....-__..-..----•---•------•--------•-------•-------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, a law „and^rul and.r ulations of the San J equin Local Health District. (Signed} 1-1 - --•-•-- --•--------------- -----{Owner and/or Contractor) By---------................................................. 1 itle _ --- ------ - ---- --------•-------- -{ (Plat Qlan, showing size of lot, location of system in relation to , buildings, etc., can be p ced on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY--.-- REVIEWED BY ..................... DATE_ _._..------ -•-----•--••------•--•-----•--- . .................•-------- -----------------------------------------•----------------------•---- DATE. BUILDING PERMIT ISSUED------------------------------------------------- -------------------------------------- DATE--------------•-------._-- Alterations and/or recommendations ------------------------•--------•-•--------.------------------•-•- ...... ..............•...--- FINAL INSPECTION BY:.. _ . .. . _ .. Z ----------------.. Date...... SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Maxelten Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California, Lodi,Califarnia Manteca,California Trocy,California