SR0083847_SSNL - Laserfiche WebLink

Home Browse Search

FOR OFFICE USE:APPLICATION FOR7SANITATION PERMIT Permit No: .--- --- Complete in Triplicate) s Date Issued This Permit Expires 1 Yom,From Date Issued Application is hereby made to the Sdn Joaquin Local*Health District fora permit to construct and install the work hereir.described. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: JOB ADDRESS/LOCATION -----------------------242 Car ent CENSUS TRACT ------------------------=P------ --r--Ad'----------------- -- owner'srName ._Ted__W_illAamS------------------------------------------------------------------ --- •-- Phone b2-- Address k----- Sa ie-------------------- Cit Stockton Contractor%, .NameB:lackazd'_ installation,w i l l_serve s`,Sep_tjp_ Tgj2 k-----------------------------.License # 268-9-r5 -------- Phone 4{3--'l0-4.8--------- Residence] Apartment House' Commercial []Trailer Court ; r r Motel F-1 Other ----------------------------------------- Number of living units:-.,-, ------ Number of bedrooms ____ _.___Garbage Grinder Lot Size ---2__lCz'eI ---------------- ZI Water Supply: Public System and name ----------------------- Private Character of soil to a depth of 3 feet: Sand' Silt Clay Peat Sandy Loam Clay Loam.E] Hardpan Adobe g Fill Material __.- ------- If yes, type ---------------------------- Plot plan, showing size of lklocat.ion of system in relation to wells, buildings, etc. must be placed on reverse side.) NEW INSTALLATION: (No septic tank or`seepage pit permitted if public sewer is available within 200 feet,) Ilk r Size__ '4"X6'X 10'_ Liquid Depth _--____---5_ PACKAGE TREATMENT [ ] SEPTIC TANK_' Capacity ------Ype 4--,1600 T S Material_concre_te No. Compartments _---_-•- ------------- 20' Distance to nearest: WellSfl_!---------------- --;ti- Foundation ------------------- Pro p. Line .- --------------- F LEACHINGLINE ] No. of Lines fLength of each line-,,-___85°_________...... Total Length ---170'---------- 2------------De"p th Filter, Material ------1-91'----------•-----.-------------D' Box _1__.-___ Type Filter Material Distance to nearest: Well ____ __ -- Foundation_:15 s---: -•=! Property Line _______ Q ---------- I 36- 77-7 Rock Filled Yes M No SEEPAGE PIT [$Depth ----2.5'--------- Diameter ---------}-- -- Number ------------ ----- -- 1 Water Table Depth ------------99-0 -- ------------- ---Rock Size ---2n------------------ 100Foundation100°----- Prop. Line'=---E Distance to nearest: Well ....3_00!------------------ REPAIR/ADDITION(Prev. Sanitation Permit# ----------=--------------------------------- Date __--------------------------------) P Septic Tank (Specify Requirements) ---------•1600---gall --------- t i-------- j Disposal Field (Specify Requirements) ------------- P-it ----- Y f f application an and that the work will se F that I have prepared this pp ------------------- ----- ----Y---------- -------'side)v - ::. I hereby cern p p done-in accordance with San Joaquin County Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local Health District. Home owner or licen- sed agents signature certifies the following: I certify that in the.performance of the work for which this permit is .Issued, I shall not employ any person in such manner as to'bec a subject to Work an's Compensation laws of California." Signed Owner Title __-------------__.__G3ntractia __---_.__-_.__----- By ---BJfBaa-ekar -------------------------------------------------------- ifIother r than owner) E Olt EPA NT SE ONLY t APPLICATION ACCEPTED By,(.,-",--DATE BUILDING PERMIT ISSUED ----------- --- - DATE ADDITIONAL COMMENTS ------------- ---------- i n-------------- ---- - ---------- t 00''1 rr. r pa Final Inspection by: _ to SAN JOAQUIN LOCAL HEALTH DISTRICT E. H. 9 1-'68 Rev. 5M