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FOR OFFICE VSE: S: v } g � APPLICATION-FOR-- SANITATION PERMIT Permit No„-:....- G �P..1. ---------- ------ - -- -- - --- --- (Complete in Duplicate) Date Issued ----- -------- -- This Permit Expires 1 Year From 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 is made in compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION-_________732 S©e Cardinal Avenue Stockton -------------------- Owner's Name--------------••------•------•---•---- 1ill3------------------------- ------------..._..-_.... Phone_._HQ.-- 45--- ...... Address........................................---------------siame__-............. -•-------------------------------------•-•-----••••t�!:.. t Contractor's Name----!he...DAY &---NIGHT---Se_ ttc--Tank_-Sery�c�------------- --- --• Phone ` ► Installation will serve: Residence � Apartment House E] Commercial L] Trailer Court ❑ Motel ❑ Other na ck Bar Number of living units: ___I' Number of bedrooms ___21_ Number of baths .1___ Lot.size -___1 -------------------------_ Water Supply: Public system ❑_Community system[]..-.Private..(M—Depth-to'W6ter Table 7-16 ft. "C4iar-acter of soil to a depfh of 3 feet: Sand ❑ GravelF] Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe[ xHardpan ❑ Previous Application Made: !1f yes,date_________________I No ❑ New Construction: Yes ❑ No'[1 FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool-permitted if public sewer is available within 200 feet.) � 1 Septic Tank: Distance from nearest well_________________Distance from foundation____.,-_---__.___Material........................................ EZi.sting No of compartrrlents------- .`.S'�=' ------------,___Liquid depth--••-•-----------------•--Capacity-----.........:.._..... Disposal Field: 11 Distance from nearest wellL50—t......Distance from foundation------3. .._....Distance to nearest lot line..... it EEL st ing umber of lines---------- _I _, �.. _ g ._f,ea 1QQ!..---------Width of french-----.--24t--------- -------- N �____ ____ __________Len th of each Zine_______ 4 & ADD J Type of filter material_ ePt__.R)<f_)_Depth of filter material----------3-q______Total length____-_._____3.00.............. ..-___-_ Cl rr (.1u Seepage Pit:/ Distance to nearest well QQ....-;Distance from foundation_.....�.QQ-_---.Dist}nce to nearest lot line_____- .0-__.. Number of pits_______.--- __Lining-rile#erial---R -k.•--.---Size: Diameter---` .. __=----Depth--•-•- - _---.-•.--•_-------- L_ �..�,�� ,. , Cesspool Distance from nearest we]l-----------�_--.Distance-rota_foundation___.':________�_____.Lining-material_._.__._._t_________________ _______� 0-� zt.. _Size: Diameter----------------- -------------------DEpfh------------- �-T`,":�-_- --------- -...Liqu� Capacity------------•---------•-•--gals. . ,. 1 Pr y Distance ffori5`nearest welh - _-___-_-_.______________Distance.f or m'nearest 6uildin ' { E 9 +..._.... 'F GAY Distance to nearest lot line-------------------------`.�✓z---------------•----- 'r------- --•--•---•------------------ --------- Remn deling and/oi' repairing (describe):------ -------- '----------------------------------------------------------------- ------------------- ---•-•--•----••-----------------•1=--•-•-•- . ........................ --------Supple_meutary--DraLaa-p------ --------------------------------------------------------- -------- a Y - -- ..-_ ----�:..wT I hereby certify that I have prepared this,application and that the work ll be done in accordance with San Joaquin County ordinances, State laws, and rules and regulatio the San Joa uin Local ealth District. (Signed)..........T_ha..D:AY___&---NIGH�T__.S_e. ti'c--- . e -e.--------------------------------------------------(�� Contractor) B - .. -------------------- -:........w_-_—, -. _ ,--'.- (Plot plan, showing size of lot, location of sysfe I re a ion to wells, buil s, et ., can be placed on reverse side). l FOR DEPARTMENT U ONL• APPLICATION ACCEPTED BY----------------------------------------------------------------- - i---�-1-�-- DATE----------- �----d-�-----'-=------- ' REVIEWEDBY---------------------------------------------- --------------------------------------------------- ---------- DATE--•----•--•--------------•------------------------k------ BUILDINGPERMIT ISSUED---------------------------------- ----------------- ............... DATE-------•----------------------------------------------...... Alterations and/or rata mendations:.. -----.-- .................... - --------- 9 -----....._. ..-----•-•------- -----------------•-- _____ _______________________________________________________________________________________________ i r7 FINAL INSPECTION BY:...- � ' { :- Date... . —42— SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California ES 9 REVISED S-S9 2M 5-61 ATLAS I