Laserfiche WebLink
A,LICATION FOR SANITATION PEI T Permit No. .. 1.46 <br /> p <br /> (Complete in Duplicate) / <br /> Dote Issued ._......��..��.-. <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> - -- <br /> JOB ADDRESS AND LOCATION.......... - J,0.. ------1 ---------------------------.--------- <br /> ►- Owner's Name---:, - ---------- Z '- `...-- - . ---- - --------------'---................... Phone--------------------•----- <br /> Address - �F 7Q + . `-- . . . •-•--••-•---------------.......�.--------...................-............. .... <br /> N ..---------- <br /> Contractor's ame- - <br /> • ---�-- - --- -------- --------------•----- - - <br /> .......--- ......---- -----•---..... Phone*e-�-7ln.Q..7 <br /> Installation will serve: Residencq�_ Apartment House El Commercial [I Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: /... Number of bedrooms ?,. Number of baths ....A. Lot size ........?/0--.---,X.-/Q.----------------- <br /> a— Water Supply: Public system Community system ❑ Private ❑ Depth to Water Tableft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe j `Hardpan ❑ <br /> Previous Application Made: Yes ❑ N-ONew Construction: Yes 2L_No ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> i <br /> Septic Tank: Distance from nearest well.- -. /yl�(Dstance from foundation.... '�..._....Ma erialr - ._............... ._-.-.--... <br /> C` No. of compartments......------..Size-r�.J.-, . ,..Liquid depth......�D.........-Capacity.......Q-0.-. >-. <br /> L <br /> Disposal Field: Distance from nearest well--- from foundation.. Lrr- ...Datence to nearest lot line---lT --�. <br /> Number of lines............... ..........Length of each line....... c AA �,,.Width of trench........42-.1c.............. <br /> Type of filter material._f�.--..54Depth of filter material._.._ ...K..-.---.-Total length...._,-----------------. <br /> i <br /> Seepage Pit: Distance to nearest well..A/ 7--d Distance oun gtion...r -..-..Dis awe to nearest lot line.---.e..b <br /> L Number of pits......./------------Lining material... Diameter- ..........Depth..... <br /> . <br /> Cesspool: Distance from nearest well.................Distance from foundation---------.---------.Lining material---------.--------------------------. O <br /> ❑ Size: Diameter . ......--- - .. -.......Depth....--------........•---------........ ....Liquid Capacity-.............-----------gals. <br /> L Privy: Distance from nearest well--- - ------------------------------------------Distance from nearest building.......................... <br /> ................ <br /> ❑ Distance to nearest lot line ------------------------------------------........-----•-.........-............—...................-------•...---- ....... <br /> LRemodeling and/or repairing (describe)--------------- ------------------- --------....._.....•.........--.----- --------------------------------......... ...-......_.......... <br /> ---------...........................------------------------=----------------.---............-----. .---•--------------------....------------••-•--------------------•-----.....------------•------- <br /> ................•-----.................................•-------------------•---•-•-----•-----.-._••--•-------------------•••--•--------_--------•------------•---------------------------- `--.. <br /> L - ------------------------------ <br /> - - ------------------P---P---------------- ---------•-•------ --------- <br /> -- fy <br /> I hereby eerti have re ared this a lication and that the work will be done in accordeeee with San Jo--a--q---u-in- <br /> oa uin Coun )� <br /> ordinances, Stat aws, d rules end regulations of the San Joaquin Local Health District. <br /> L (S - ....'�' %'` s F ----------------------------------------------- -`. -.(Ownend/or Contractor) <br /> - - - - . �� _ E/�l_�( <br /> By:------- ....�/ ... (Tito)- . . - ----------_ <br /> (Plot plan, showing g size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> LFOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY- - -.-...... - - DATE---------�................................... <br /> .. REVIEWED BY................-------------- - ... - - - - - - - -- - DATE----.......... <br /> BUILDING PERMIT ISSUED.-----.....-- - ---- -- -- - DATE - - - -------- <br /> Alterations and/or recommendations:......................... ... . ... <br /> � .-- <br /> L -•----•- ---- -------------- - ------.. ------ ..... __ ......J �... ---........................... .....- ----... <br /> ........... -. � .-.r. ........................................ ...... `„ <br /> L .--.. .- ----- ---- ------ - - -•---- -------.----- ------ --------- -- -. ... .. . ----------- -- --- - -- - ----- <br /> FINAL INSPECTION BY: ' _ "� Date `� <br /> LSAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak St reef 132 Sycamore Street $14 North "C•' Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> ` <br /> cs—s 1s11 ,.11o0o <br />