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I\ .`` ] APPLICATION FOR"SANITATION PERMIT Permit No. --./- 4-.. r� (Complete in Duplicate)3 Date Issued .___�'_.�'3 -.4d�! Expires This Permit E s 1 Year From Date issued e !` 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. A. JOB ADDRESS AND LOCATION................1208 Coge Av-.__,__:?----------��------------------------------------------------------------------------------ ------------------7-------- � Owner s Name FZ'9d• dna `�11 3. ---St�War ,.... r ------ Phone_.._HOP---3-X1031-- Address 1208 Ciolleg Av's ` , --------------------------------------- -------•-----------------.......... Contractors Name_____ Delta-_•Septic Tank -Sery Inc.�.-_. _`' ------------------------- Trailer r �_ ------------------_ Phone..._HO.•.----3-'-"12 9- r Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: __�-__' Number of bedrooms _9--- Number of fjeths 2----- Lot,size _________.X_-_68 �Z - -----------------------______________ h Water Supply: Public system [2 �Community system El Private El Depth to-Water Table .-4-o- ft. r. Character of soil to a depth of 3 feet: Sand ❑ Gravel E] Sandy Loam El Clay Loam [I Clay E) Adobe'® Hardpan El Previous Application Made: Yes Q No ® New Construction: Yes No ❑ FHA/VA: Yes ❑ No N TYPE OF INSTALLATION AND SPECIFICATIONS: ( Pcesspool,,,permitted if public sewer is available within 200 feet.) ` Septic Tank. Distance from r No septic tank or p .nearest well from foundation___1Q�-____=Material_-�-�_�.__�em�Ii�--bY'- 61---&---4t--------Liquid depth_ -5-t----&--31-Capacity---- ----------- � No, of compartments________._.............Size..-,� Disposal Field: Distance from nearest •well__--------_-------Distance from foundation__-___-__---------Distance to nearest lot line.____-_.________ Ione Number of lines------------------------- --------Length of each line-----------------------------Width of trench : Type of filter material-------________--__ -Depth of filter material---------------- Total leng#h__-------___- __-------•----------•----- Cj Seepage Pit: Distance-to-nearest well---n0____----------Distance from foundation----1 E___.___-Distance to nearest lot line_-____,5_'______ Number of pits.... 1-----------Lining material___.r-O.O ------- Diameter----3- N -----Depth.-25- 'ft. _i'039�x- Cesspool: Distance from' nearest well___________ ____Distance from foundation ;____..fining material_________,_r,--------------------- ._ ""-------------------------------------- a --- --------- -----Li Liquid Ca aci :, ❑ Size: Diameter- ------------------ ------ -------Depth------------ ----------- - a p �tY-----------------�=;--------gals. Privy: . Distance ,from,nearest,welln-____------------------------•-----------------Distance from`rnearest building - -------------•---- v. _ --------- Distance to.nearest,,lot lone._.-----°--- `-----•-¢-------------------------- -----------------------------------=--------`= �ad3�n see • et to _ Remodelingand/or re airin escrib g�:. - pg'--;=-p 5 -8 g a Bt III: '--=-------------- / � - ' `rn�'�f s------ ---------------------- -' II --- ': _ : :: - --------- ------------------------"L------":------ ----- ! hereby certify that I have prepared this application and that the work will be done-in accordance with San Joaquin County ordinances, State laws, and rulesYand regulations of the San Joaquin Local Health District. , 98 Signed) Delta Se�atic Tankc�ry, t--- HC.r-------------------- [Owner and/or Contractor) ( 9 ------------------ ------- P arr 0 Title Gen Mgr. ---------------- Y . ---- ------------------[ ' )-------- -- .---- BY ---- - (Plot plan. showing,size of lot, location#f system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY I --DATE__" -�- G- ---------------------------- z+" APPLICATION ACCEPTED BY "` - r2 ; DATE ---------REVIEWED BY - - DATEBUILDING PERMIT ISSUED------••------------- - ------------------------------ --- _ 'Altegon and/or recommendations:-' --------• � ---- -------- - --------- ---*_ � ------------------------- - - ----------- -. ------------------------------------------ r �-- t -- -- ---- -- ------�------�- -- • �'�- %�' l JG��'�•��,�_��" �� L��U��'� ---- ------- ------- ------ ------- FIN' ----- F]NAL NPe& p c BY '' ---- - --- - --- -- --------------- -- ` Aa - `ag,-Z �� SAN JOAQUIN LOCAL HEALTH DISTRI f out American Street " reet 300 West Oak Street 132 Sycamore Street 81# North "C"St Stockton, California Lodi, California Manteca, California �raey, California'.' ES-9-2M Revised 8-'59 F.P.Co. -