SITE HISTORY - Laserfiche WebLink

Home Browse Search

FOR -OFFICE USE: APPLICATION FOR SANITATION PERMIT 7 S" 96 Permit No. .............�..� ,,,-, �•., (Complete In Tripliceh) - P * Date Issued ..��. .......... ..... .... .... .. ... This Permit Ex ires t Year From Date Issued Applicat'on is hereby mode to the San Joaquin Local Health District for a permit to construct and install the work heroin This hereby is made In compliance with County Ordinance No. 549 and existing Rules and Regulations described. PP ........... ... .... . . ...CENSUS TRACT ..................... ... i R . JOB ADDRESS/LOCATIQ.f� O�d - Phone .9. ...�11....... Owner's Name -- .- ..Y' ..... Address W/. d. ^�....... i City,/� ................... �.... llcense, ,Sa� . Phonea�.3�a��.R Contractor's Name ..A - . -'-'"'- t: Installation will serve, Residence❑Apartment House❑ Commercial ❑Troller Court 17 Motel ❑Other ...... .... Number of living units: ....-..- Number of bedrooms .5......Garbage Grinder ............ lot Size ..... ................. .Private............... Water Supply: Public System and name ................................................. ............. Character of soil to a depth of 3 feet: Sand❑ Silt❑ Clay ❑ Peat❑ Sandy loam�g Clay loam ❑ Hardpan❑ Adobe ❑ Fill Material ..... _. .- If yes,type ...-•--.... -- (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be pl8ced on reverse side.) NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) Size..5.-X.X 9.. Liquk' Depth ...6Y............. PACKAGE_TREATMENT [ ) SEPTIC TANK[ ] - y'�"� . . 6 f rMaterial. .. ,..... ... No. Compartments ...................... Capacity TYPe �E- 6 A Pp. line ..!5- Distance to nearest: Well•- - Foundation ... ........ ro .;........... IE LEACHING LINE [ ] No. of Lines . ...a- - - - l Length of each id �o Total Length .-/41 •............. 'D' Box Type Filter Material Ak% Depth Filter Material ..f................. / Property line .. .................... ...... foundation ...... ..... Distance to nearest. Well .__ No Q Q .... .....- Diameter Number ............... Rock Filled Yes ❑ SEEPAGE PIT ( ] P '- "---�-'�- � t" Depth .. . . -- Water Table Depth .. ...... .... .... ............................Rock Size . Distance to nearest: Well .......... .............................Foundation .................... Prop. Line ............... REPAIR/ADDITION(Prev. Sanitation Permit# ........ .....- _- . Date . .................................) Septic Tank (Specify Requirements) .... - ..... Disposal Field (specify Requirements)uirements) ... q .................. .. ; _ .. - .- .... ..-.. . .... .. . .............................._ ........I.................... (Draw O-Risting and required addition on reverses I hereby certify that 1 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 the Son Joaquin Local Health District. Home owner or Ilcen sed agents signature certifies the following- . this In such maimer "I certify that in the performance of the work for whlL,-this permit is Issued, I shall not employ any p as to become sub kms ' omponsatign laws of California." Q'• _.. ........ .... ...... ..... ... Owner Signed . Title ......... .. ... B (;f other than owner) FOR r%EPARTMENT US! ONLY --- �_v_.v.-W - - DALE ... . ......... ....... .................. APPLICATION ACCEPTED BY DATE .......... .............. BUILDING PERMIT ISSUEDC�;k " ' """ ADDITIONAL COMMENTS . ......................... ........ ............... ... ... . . .......... ..............._....................................... ... .... .... . .. .... ..... .. ... ..... ........ ................. ........................................................ r ............... . _. . ... ... .. . ... ` 1 . .. . . .... .. . . . .. .........Date . . �-T.�. Final Inspection by: ........... •• ••••• ' SAN JOAGIUIN LOCAL HEALTH DISTRICT �,