11408 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR SANITATION PERMIT Permit No. __If..7.4... (Complete in Duplicate) Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to construct and install theme k,heerdein described. This application is made in compliance with County Ordinance No. 549. 4 p WE 29+0 Loomis Avenue �l JOBADDRESS AND LOCATION --------------- -------------------------------------------- --------------------------------------------------------------------------------------------------- C . ead L•R--------- Phone-------------------- .. Owner's Name - - R Same as above Address -•--------------------------------------------------------------------------------------------------------------------- ------------------------------------------- Contractor's Name --------- Parrish Ino Ho 6-9607 ----------------------------------------------------------------------------------------------------------------------- Phone ------------------------ ---------- Installation will serve: Residence E2f Apartment House Commercial ❑ Trailer Court ❑ otel ❑ Other E]22 acres Number of living units: _- Number of bedrooms -- ---- Number of baths ------ Lot size ---------------------------- _________________________.__-- Water Supply: Public system ❑ Community system ❑ PrivateiE Depth to Water Table _40_tft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe P7 Hardpan ❑ Previous Application Made: Yes ❑ No 9 New Construction: Yes El No :F] FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or' cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well----------------- Distance from foundation ------------------- .Material --------------- _._..___-_____-_-------_________- Extgting No. of compartments --------------�o------- Size -=------------------'_- --------- Liquid depth -------- -------Capacity-----------------`----- Disposal FieEd: Distance from nearest well_________________ Distance from foundation_ _fi_��___.____.Distance to nearest lo�iir�g___ �__.___.- ��qq Number of lines ---------- �-________----_-__.____Length of each line ------ 7-----___ _ Width of trench. 75' -------------------------- Type Type of filter material --_S rock Depth of filter material___________ Total length_________ 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 ------------------------------------- El 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, State laws, and rules and regulations of the San Joaquin Local Health District. (Signed) Parrish InGt ----------------------- Owner and/or Contractor By: --------------------------------- Bi11_ WT1ght------------------------------------------------------------------ (Title)----- ESt------------------------------------ ----------- (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY ----------------------- ------------------------------------------------------------------ DATE----------- REVIEWEDBY------------- ----------•----------------- -------------------------------------------------------- DATE-------- t4-13 ------------- ------------------------- BUILDING PERMIT ISSUED ------------------------------ ----- ----- •--------------- --- ---- -- - ------ --- - DATE---- --------•------------------- -------------------------- Alterations and/or recommendations-------------------------------------------------------------------------------------------------------------------------------------------------------- ----- ---------- I -----------------------------------------------•------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------- FINAL INSPECTION BY:----- ---------------------------------- Date-------------- f -f--- --------- ------------------------------------ SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES -4-2M Revised 1.57 F_P.CO.