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� tse Permit.No. 3 ------ �.tr!��APPLICATION 2,FOR SANITATION PERMIT (Complete in Duplicate) D ate Issued --- ------ Application. is hereby made to the'San - Joaquin Local Hbalfh District for a-permif toconstruct and ins+allthe work herein described. with County O�rdin e No. 49. This application is.made in compliance i w ----------------- -------------------- . . ...... ..... ------------- ------------- JOB ADDRESS AND LOCATION -------- Phone------------------------------------ - - --- - ------------ - - O -- - ---------i--------------------------- ------------------ ----- ------ wner's Name--------L ------ ------------------------------------------------------- T, ---------------- --- Address-- -------------- Phone----------------------------------- - ----------- ---- - -------------- Contractor's ,Name.--- Commercial F1 Trailer.-Courf 1p�,<otel 0 Other [I Installation will serve: Residence ❑ Apartment House El � - Lo size --- ---------------------------- aths t � __/----a-% ---- Number of living units: Number of bedrooms ---46- Number of b Water Table 9� - I . I ft.- 7�,'C mmunity'systern E]'-.Privafe El 'Depth'to Wat Nt` Water Supply- Public. systemL 0 Clay Loam El Clay 0 Adobe *-TTardpan Character of soil to a 'depth of 3 feet- . Sand Fj Gravel,n , Sandy Loam ❑No FHA/VA-. Yes E] No 9�� on' No V�' New Construction: Yes 0 Previous Applicati i TYPE.OF INSTALLATION AND SPECIFICATIONS: tank or permitted if public sewer is available within 200 feet.) (No septic t ------- irom n'ear'est well----------------Distance from foundation-------------------Material--------------- ----------------- Distance Sep{'�tfa n u --------------------------Capacity------ ---------- N -;f c-ompartments.------ ------I------------Size------------------------- _,___Liq id dep�h No. V 0 nearest I it line------------ Distance from nearest N e nclatio ---------Distance f well_ from fo�u' 'Dispo F 4ee __4------------------- --- 'p" _'Ue�'gth6f each line ------- ------Width of trench Number of lines ------------1 ----- --- - ------------------ 'r .1 Type of filter �al---- IA--Depth of filter ir�afer'i f ____Total length------ --- p .1— - Di'tance to nearest lot line_______.___._ s -bis _t�nce-from' foundation-------—------ s stgric; f' Di e a g 4" 0 nearest well-------------- ----.Depth------------------------I .Number of pits:----- ----------il_ Lining material----------------------- Size:.Diameter--- --------- .1 7... .o ---------------------------------\ rom foundati n-------------- ---Lining material. esspool m nearestweil--: -------Distance f og Dis+ance from ---------�g 111. . . 9 1 - __:-----Liquid Capacity------------------ ------------ ------------------------------- Size: Diameter--------------------------- ---Depth Disfance from nearest building------------------------------------------ Privy: -4 Distance from nearest Well-------------------------- -- --------------------------------- [ -F-[ Distance to-nearest lot lin ---------------------------------------------------- x- --—------------ modeling and/or 'repairing (describe]--------------•-- Re ------------------------------------------------ _............................ ...........I-------I------------------------------- -------------------------------------------------------------------------------------------- ----------------------------------------------------------------------i----------------------------------I------------------ ------------------------------ ------------------- ----------------I-- ----------------------------------------------------------------------------------------------------------------- I hereby certify that I have prepared this application'and. that +he'work will be done in accordance with San Joaquin County ordinances, State laws, andAules and regulhtions of the San Joaquin Local Health Distrid. ctor) -------------- (Signed)-------------- -, 7t -'/--------------- ----------- ---------------------------(Title)---- ------ By:.-__-------------------------------- --- -------- rem reverse e ji (Plot plan. showing size of lot, I tion of system-in relation to wells; buildings. etc., can be place FOR DEPARTMENT USE ONLY. -------------------- -------------------------------------------------- EPTED BY--------------------------- ------------------------------------I APPLICATION ACC ------------------------------------7-------- --- DATE----------- --------------------------------- REVIEWED BY------------------ BUILDING PERMIT ISSUED--:------------------I-------------------- ------------------------I-------- --------------- ----------- : . - ------------------ --- -- -------4 mi�endationv--------k--- ....... ------------------------:---- �, AlterationLand/or recc ---------- -___ 4ha- x > I -- -------------- --- -- ----- ------- -I---- ----------------- A& ----24 ---- - ----- - - - - ----------------------------------------- ----------------------------- --------------------------------------:------------- n 1-1-------- ------------------------- _!---------------------- ------------- ----------------------------------------------------------- -------------------------------------- ..........I ------------------------- ------------------------------- ---------------- -- ------------------------------------------------------------------------- -------------------------------------------- ----------- ----- ------------------------- :!7--- ---------------------- - Date---- -------------------------------------- FINAL-INSPECTION By.: H DISTRICT SAN JOAQUIN LOCAL HEALT L 814 North "C" Street 6ak Street 132 Sycamore Street 130 South American Street 300 West Manteca, California Tracy, California Stockton, California Lodi, California ES-9-2M Revisea ).57 F,P-CO.