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FOR OFFICE USE,: � _ o-4-1_a_ .-.x..51:.----�1; ..... ... APPLICATION FOR SANIT-ATIO�J PERMIT Permit No. /Xl------------------ - (Complete in Duplicate) ' ----------- ---------------------------- This Permit Expires 1 Year From Date Issued Date Issued ._....._l✓._..... I Application is hereby made to the San Joaquin Local Healfh District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No: 549. A . . JOB ADDRESS AND LOCATION___- I...Cherryl-and Stockton Caribou Trailer Park .� ---------------------------------------- ----------------------------------•--- Owner's Name Qli--------------------------- ----------- Phone.--93-1-3.1-1.1 --•----------- -- -- ----------------------------------------------- Address------------_---b52_Gratton Ave �--------.Stockton --------•----------------------- Contractor's Name..... n-- DAY & I�TIGI3T -Se p---- c Tani- erYicE -------- ------------------------------------- Phone4�?b_:3$41---_---------- Installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court Motel ❑ Other ❑ Number of living units: -------- Number of bedrooms .------. Number of baths -------- Lot size _- QQ. _- ..1. OQ1._.....___.................. Water Supply: Public system ❑ Community system ❑ Private g; Depth to Water Tablebfl.... ft. Character of soil to a depth : Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay [] Adobe ZI Hardpan ❑ Previous Application Made: (If yes,date.--9.�7/65-__..) No ❑ New Construction: Yes ® No ❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) l Septic Tank: Distance from nearest well---1 001_____Distance from foundation------1 ..........Material--- onCx Pte------------- ------------- © No. of compartments------.2----------------Size2__4_'___x--J4t-_x--62liiquid depth----- 6....... --------Capacity_.3600__g3Ls. Disposal Field: Distance from nearest weli.-.$0_f-------Distance from foundation---IQ1----------Distance to nearest lot line---5. -__....... ® Number of fines---------3 --- ---------------___Length of each line..1.0Q!___.--------_....Width of trench......21�'.t.,.._..- Type of filter material---Septi--Rt Depth of filter material----1-9-l'l------------ ota! length---3001----------3-°-7-_- rr � Seepage Pit: Distance to nearest well-----1.00_---------Distance from foundation--...10-._.._...Distance to nearest lot linea-1.-......_--_ ® Number of pits--6-----------------Lining material---ROck----------Size: Diameter----3 11------------Depth----.-_25�---------------- f�f Cesspool: Distance from nearest well.................Distance from foundation--------------------Lining material--------------.---------------------- 171 ...__.__......_- -_._❑ Size: Diameter---------------------- -----------Depth ---------------Liquid Capacity--,.------------------------gals. Privy: Distance from nearest well................. --------------------Distance from nearest building-----------------.___-...._ 171 Distance to nearest lot line--------- ------ --------------------- Remodelin and/or repairing -describe-•--------- ------------------------------- ----- --..Y'�-----•----------------------••----------------- �= t --------------------------------------------- -`r< - 9---s cxP ti—m--h�.11--�a�a�z��.P�--�`----- 1 ---------------------------------------------------------------------------------•-------------------•----------- r II: --------------------------------------- ------------------------------------------------------------= = ------------------------------------------------------------------------------------- ------- --------------- I hereby certify that I ve prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, andJ6eele�sj�an/d regulations of +he-San Joaquin Local Health District. (Signed)-------- e1Jar� ili�ht - Iz:, �" wed/ter i-'TIS..T:�NK S FZVIGE -----------•---------- _—,._Contractor) i --- ----- - - ------ -------(Ti+le)- ------------ --------------------- --_ By.---• 2915 E-Miner Ave_, - HO.6-3841 I {Plot plan, showing size of lot, location of system in rela n #o.ays, buildin , ete:, can be placed on reverse side). FOR DEPARTMENT USE dfiLY APPLICATION ACCEPTED BY--------- -- - / ---------------------------- -: DATE------ ~� REVIEWED BY----- -------------------------------- DATE --------•-------------------•-- BUILDING PERMIT ISSUED --- ----------r----------- - DATE �-: -----; --- ------ Alterations and/or recommendations:----- L_.:. ... .. . __...s- f f �`'� . ,�-- ---- ----------- 77��, - � --- nJ{ ��- � ----•----- - ` -�- [ ------------ ------------------------ -------------- ---- ---------------- FINAL INSPECTION BY:..... 4{.__--•-rAN - Date t � /.fir OAQUIN LOCAL HEALTH DISTRICT _ 7601 E.Noxelton Ave. 300 West Oak Street .124 Sycamore Street 205 West 9!h Street {. �. -Stockton,California Lodi,California Manteca,California Tracy,California �O/yam_