2232 (2) - Laserfiche WebLink

Home Browse Search

r I APPLICATION FOR SANITATION PERMIT Permit No.4 ___3__ (Complete in Duplicate) Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application Ps made in compliance with County Ordinance No. 549. 5.rte JOB ADDRESS AND LOCATION...... 5--- I� .� � _�1'1---------- -- --t----- - -- Phone-----6,_ _, Owner's,Name------------------------------------ Address--------------- -----------------------------------Address-----------------------------------------------, f Phone___{ Contractor's Name--------------- -----?jVl � - -- r Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court [I Motel ❑ Other [I Number of living units: _1!' Number of bedrooms J--- Number of baths ---7,-- Lot size __cQ_P_-x---_/ -©-- ------------------ ! Water Supply: Public system ❑ Community system ❑ Private I& Depth to Water Table _,�49ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe Z, Hardpan'❑ Previous Application Made: Yes ❑ No A- New Construction: Yes ❑ No ❑ M TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) ptic Tank: Distance from nearest well-----------------Distance from foundation--------------------Material_____-_-__-_-_________________-_______________- I No. of compartments--------------------------Size-------------------------------'Liquid depth--------------------------Capacity------ posal Field: Distance from nearest well________________Distance from foundation------------.-------Distance to nearest lot line-_-_____.________ Number of lines Length of each line ------Width of trench----------------------------------- '! Depth of filter material-----------------------Total length------------------------------------------ Type, of filter material_________ -------------- � . 99 Seepage Pit:S Distance to nearest well,f__� _____Distan f fou ation___1 _._.__ Di tante to nearest lot ,. yNumber of pits---- --•-------- Lining materials - size: Diameter__pe --"------.Depthu�- -------------------- ool• Distance from nearest well-----------------Distance from foundation____________________ Lining material__________-_______"________.._.______. Size: Diameter--------------------------------------Depth------------------ ----------------------Liquid Capacity----------------------------gals. . Privy: Distance from nearest well-------------------------------------------------Dis#ante from nearest building--------------------.--------------------- Distance ------_-------- ---Distance to nearest lot line---- --- ---------------------------------------------------------- RemodeI- and/or repairing (describer----------- '�------------ _ -- `= ---------- -------- ------------------------=------------------------ -------- ----------------------- --------- - 7 -Z-- -- -�"-- -- --------------"------------------------------ =�------------ ---- - -------.-------------- -------------------------.---------------------------------- +� -------------- I hereby ceffify that I have prepared thi application and +hat the work will be done in accordance with San Joaquin County ' ordinances, State laws, nd, nd regulations of the oaquin Local Health District. w I d)-- (Signe ---- = -�-- -------`- ---- ------------------- ( ontractc:•1 ---- ------- r8 = -- --- - -------------------------------------------------- {Title) cfJ/� (Plot p n, s size of lot, location of sy e in relation to wells, buildings, efc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATIONACCEPTED BY --------------------------------------- --------- ---------------------------------------- DATE- REVIEWEDBY DATE------- --------------------------------------------- BUILDING PERMIT ISSUED-------- DATE----------- 10------------------------------------------- Alterations and/or recommendations------------------ --------------------------------------------------------------------------- - ----------------------- FINAL INSPECTION BY:_. ---------------- ------------------- Date SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 3oo West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-"-9-2M 8-51 Revised W-2100