7372 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No. .._(--.3•..7.32._-L. (Complete in Duplicate) 41Date Issued Applica4ion is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with ount,y Ordinance o. 549. JOB ADDRESS AND LOCATION �G� 1"7✓_. _ C S7-225'—o _ ' Owner's Name.---------y-�•--- �'1.��7_��-------c �f ' � -..t'zry�- - -- 7 /��- ---- -------------------- .- Phone .-. r� Address--------•--•------•••---..�.�E.-.6..�-----k--`•--��---••------•----•-----•--------------- -•- •--------• --- -------------- Contractor's NameT ��-.-, /-- K-- r - ----------- Phone-w. ,70lo t Installation will serve: Residence [Ok�Apartment House ❑ Commercial ❑ Trailer Court ' ❑ Motel ❑ Other ❑ Number of living units: --�N mber of bedrooms __Number of baths _?Y ---- Lot size ---��- ---�-r L® 'f Water Supply: Public system Communit system Y y ❑ Private ❑ Depth to Water Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe Hardpan ❑ Previous Application Made: Yes []I No Er-�;N`ew Construction: Yes ❑ No ❑ ' TYPE OF INSTALLATION AND SPECIFICATIONS: 1,52 (No septic tank or cesspool permitted if public sewer is available within 200 feet.) is T Distance from nearest well-----------------Distance from foundation---------- -------, C' - - Material--------- -------- -----------•---- -------- --- � No. of compartments------ ---- --------------Size--------------------------------Liquid depth-- ---- -- ----_Capacity------ ------- s Id: Distance from nearest well..........:.... Distance from foundation---___------.-.....Distance to nearest lot line--_---_------__. Number•of lines-----------------------------------Length of each line------------ ------ -- --.Width of trench st l ---------------- .� Type or' filter material--------------- ---------Depth of fiiter material----------------------Total length---:---------------------- -------------- Seepage it; Distance to nearest well $7.R/-------Distance�om foundation-- -� Dist nce to nearest lot lin . C3_ Number of pits-----._----_----__.Lining material--�--�.--�.__-/ !f , �._.--.Size: Diameter--- _--- Deptn_c;,_7___j _- °�1^�� Cesspool: Distance from nearest well---------------- Distance from foundation ...__.Lining material------ _-__._--__--.- ❑ Size: Diameter----��---- ---------- ---------- Depth- -------------------------I------- --------------- Capacity...=------------------------gals.=. EJ Privy: IJistance from nearest well........................ .-_--....-Distance from nearest building---- ------- -------- ------------------- Distance to nearest lot ----------------------------- ----- Remod ing an /or repairing (describe):-.-.--[tC�----_ � �� ----- . . ... e r . I -•-----•-----•-- •--- ------------------------ -- -----•---------------- ---------------------------------------- -----------•------------•------------------------•------------------ =;------------ I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and1regulations of the San Joaquin Local Health District. ' DAY$ NI'GNT (Signed)..-- ---------------Septic-Tank-Service------------------- ]206 So. Eldorado HO 2-7046 ' ntractor sy:..� _ - - - Title---- - ---.- .. r --- --- - tae tAn alif-------- ----- ( } (Plot pian, showing size of lot, oca ion'o� system in rely to wells, uildi s, etc., can be placed on reverse side). 1 FO DEPARTMENT USE ONLY 1 APPLICATION ACCEPTED BY--- .. DATE----_-_ REVIEWEDBY------------ �,r --------------------------------------------- -------- ------------------------•-------- DATE_--� - BUILDING PERMIT ISSUED------------ -----------------------------------------•----- ------------------ --------------------------------------------------- DATE------ -_- --- Alterations and/or recommendations_______________.---__----__. -- ----------- •------------- --- J ---------- � =--------- --- ------------------ ---- - FINAL INSPECTION BY:-----. - L-/_ .- ,�r� _&------------------ ---- Date SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockfon, California Lodi, California Manteca, California Tracy. California - ES-9-2M 145446 ATWOpn 12-54 1h , 14