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r�.�6 10 permit is ncceaary --_ APPLICATION FOR SANITATION PERMIT Permit No. _-..f_EzZ- w a (Complete in Duplicate)" .>� Date Issued Applica+ioh 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----1-80?------E, Qhart�r--Wgy_-,--- Stockton-, -- General Truek Sake Owner's Name------------------------------- -- West Coast Machinery Co. —� Ha. 64321 -- ------- - -- -------------------------------------------------------- Phone.-Ho. 807 E. Charter Way Dan Weidner ordered work--------- ••----,. - - ------------------------------------ •-•--•-----:-----------------------------------••---- -----•-••------------------. --------------- ank Contractor's Name----------Deft&---Septic_-------- Service --____ Phone.. _-' 269--------------- - - -- e Installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court ❑ . _Mo el ❑ Other ❑ Number of living units: ________ Number of bedrooms :__.___- Number of baths -------- Lotsize ----------- `. Water Supply: Public system :91 Community system ❑ Private ❑ Depth to Water.Tabie sQ__ ff. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam'❑i *C1ay.Loam ❑ Clay ❑ Adobe ® Hardpan ❑ i Previous Application Made: Yes No pp ❑ New Construction: Yes ;P No ❑ r TYPE OF INSTALLATION AND SPECIFICATIONS: O. +4.(No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well--;-----------------Distance from foundation-------------------Materiai---------------------- 1771 No. of compartments-------------------- --Size--------------------------------Liquid depth--------------- Capacity Disposal Field: Distance from nearest well - Distance from foundation--------------------Distance to nearest lot line_-----_._ _._... ❑ Number of lines-----------------------------------Length of each line------------------------------.Width of-trench---___.__--_---_--- J Type of filter material------------------ -- De o -Depth f filter material-------------_--_--- Total length----- Seepage r o� 5t Seepage Pit: Distance to nearest well.___.IlO� -----Distance from foundation_____�-_-....._._-.Dista;ce to nearest lgt�fne_________________ E i Number of pits__-___ .-_I------Lining material--�7Ti_C .--.Size: Diameter___-x ___ ._Depth �______________ Cesspool: Distance from nearest well-------:---------Distance from foundation______________ - R: -----.Lining material-------- - ---------�--- -=---- El lie: Diameter-------------- ----------- - ----Depth------------ ---------•---•---------- ------------Liquid Capacity- ------------------------gals ". 1 , Privy: Distance from nearest well ______ -------------------------------------Distance from nearest building-__- _____________- __'_ --------- ❑ Distance to nearest lot line----------------------- Remodeling and/or repairing (describe)---------_the_-seepage_ pit is___t_o be used f----------------------------------- . r ean water ' ... frogm------of Ice_ cooler---o_n_1y _---___ ta_ be_-pi-ped direetly_ From t _e cooler into the_-pit_-_w if sny ocher inateriaZ excapt clear inratere t0 be p3pcd i.rio ----- -------- -------- -------- this pit i -:will be in violation of the Water Polution Law;-- ----------- ----- -: 5 --- ------------------ - ------------------------------ hereby certify that I have prepared this application and that tete 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) _ Delta , 9 )- ------ -------------------••------•----------------------------------------------- --- -------------------------------------------------------------:_ (Owner and/or Contractor) Sy:--------•-----------PW--------------------------------------- ----------------------------------------- ---------------------(Title) -Gen._M9r. (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 ACCEPTEWBY.'------ - ---------- t Y i--------- ------------ -------- DATE.. REVIEWED BY-- ,-. -------------------------- BATE �dk ------------------------------------ BUILDING PERMIT ISSUED = = � -------------------------- � --------------------- ------ DATE--------•------•----------- Alterations and/or recommendation`s:`____-..- ------ I -------•-------------------- -- -- -------------------- ---- --- " ------------------ ` : "01 '�------- ------------------- ------------------------ ---------------------------- ---•----- � --_...---•- ---•-----------------------------------------•--------•- -- -----------•--------------- FINAL INSPECTION BY: - _�,--------:--- Date 7- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 614 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES 9-2M 145446 ATWUUP 12-54