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I-UK UrhECE USE: _ .ff=_45.�1----- -------------- 1.----- ----------------"--------- -- ------ APPLICATION FOR SANITATION PERMIT Permit No. ------ ------------- ------------------------------------ (Complete in Duplicate) ----------------------------------------- --- ---- ---- -- This Permit Expires 1 Year From Date Issued Date Issued 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. JOB ADDRESS AND LOCATION..___1619 Chlmiale .�f3. Stockton -- ---- ---------- ---" Owner's Name axidard Sam $ �at�and ry,,W• -------------•------------ - ----------- -------- -------••----------------•------------------------- - - --- - ... Phone------- -----------••------•- Address ------ 1649 Willow Pass Road; Concord Calif., ----- --- -- --------- ----- The DKY & NIGHT Septic Tank Service - -Contractor's Name ------ X66-3$41 ----•------------------- ---------- ------------- one Ph ---------------------.....-------•- ------------------------------------------- Installation will serve: Residence F Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: 1----- Number of bedrooms ?----- Number of baths _1___ Lot size __100 t--X 50t -------------------------------------------- Water Supply: Public system 9 Community system E] Private [:] Depth to Water Table Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe Hardpan ❑ Previous Application Made: (If yes,date------_ -----------_) No ❑ New Construction: Yes [j' No ❑ FHA/VA: Yes ❑ No Ell TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if-public sewer is available within 200 feet.) I Se f' Tank: Distance from nearesfi well ___ _____Distance from foundation__-;O=__-- -----Material __ �r1CI'tt No. of compartments---------2_----------__Size_ t tt -- - 3----Liquid depth----%-- ----- ------CepacitY-"--800__Ga1Se Disposal Field: Distance from neares weRone--.--_Distance from foundation___---lo�_ -_.Distance to nearest lot finest Number of fin es---.------"----- ------------------Length of each line-----6n ---30t__------Width of french Type of filter, materialPIPVt cC__MC--Depth of filter material___-.- -"--Total length__- ____9Or_ --- Sege Pit: Distance to nearest well- a,dt �' - OF1C _-- __Distance from foundation _______ _________ Distance to nearest lot line__.:'---------- Number of pits-------g------------Lining material___] --_- -Size: Diameter._33t-----_-------Depth---.-25 E_._.__----- Cesspool: Distance from nearest well-_______________ Distance from foundation__._.. ._..__.__.Lining material----------------:_-_ ❑ Size: Diameter------ ----------- -------------------Depth----------------------------------------------------- • Liquid Capacity ---------- -------------gals. Privy: Distance from nearest.well____ ___________ Distance from nearest buildin ❑ Distance to nearest lot line------- ----------- Rem elinq, and/or e firing e �r : stn g_"tank inadequate-and too Close to buil o allow ega`i remo dreg dibe)ouse... Ilrairiage is 3aiiadequate acid sauraed --tberefo"re a rietr P ------------------------------------------------- ------seirage d3sposa1--syste�►__is-"regiiz:reel.---;--- -------------- - -----------------------------------•------- -- •------------------------------------------------------ -------------------------------------------------- f hereby certify that I have prepared this application and that the work will done in accordance with San Joaquin County ordinances, State laws." rules and regulations a Joaquin Lo al H h District. ; (Signed) --------------- - n �I` �iE-------------------- fIn ° SEPTIC TANK SERVICE ----------- -iN Contractor) ---- --- Title_ - - - -- - -- ---- --=- plan, showing size of lot, location�'system in ion to wells;�bulldi s, etc., can beplacedsn_reyerse.side]. _- FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY_. 4LU_ _- - _ D REVIEWED BY------------ - -------------- ATE--- �. r _'. -------------- ------ - -------- . ---- . DATE BUILDING PERMIT ISS".IED------------------��.`�-------------------------- --------------------------------------- -- DATE Alterations and/or recommendations:-- _ ..... ll_ ----------- o� --- ------------------------------ ------------------------ -----------FINAL INSPECTION BY:.._A.1 ... - Date---- _- T SAN JOAQUIN LOCALHEALTH DISTRIC/T 1601 E.Haxelton Ave. 300 Wes+Oak Street 124 Sycamore Street 205 West 9th Street Sfockfon,California Lodi,California Manteca,California Tracy,California F.P.Co.