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FOR OFFICE USE0.2 54 I- _2___ _.. �APPLICATION FOR SANITATION PERMIT Permit No. 7-------- - - ------------- ---- ------�.14V--------- (Complete in Duplicate) - "_.-__."-- lDate issued _�__.f,��_-.� This Permit Expires 1 Year From Date Issue .. I Health District for a permit to construct and install the work herein described. Application is hereby made to the San Joaquin Loca 'This application is made in compliance with County Ordinance No. 544. 7 JOB ADDRESS AN LO ATIO ____,. Q_ -Lb- =�' ,`� Y ------------------------------------ -------------------- f! Phone Owners Name_-___ , (Address = - - ---------- ----------------------------------- ---- -T = �� ' '' - Al ----- - Phone - c,Cr Contractor's Name---- �7.. �-- -- - Commercial Trailer Court ❑ Motel ❑ Other ❑ Installation will serve: Residence Apartment House ❑ ❑ i „ i _Number of living units: _VCommunity Number of bedrooms__ Number of baths Lot size xWater Supply: Public system system ❑ Private ❑ Depth to Water Table -------- f+. Adobe Hardpan ❑ Character of soil to a depth o13 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam.❑ Clay❑_. - Previous Application Made: (If yes,date_. ^---; ,_-- -.- -). 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 240 feet.] . ,,. e , Septic ank: Distance from nearest well _4�_-______Distance from foundation__,�p�.---- -Maternal"- CG�}r.- c _______ -__f.. i f . t - --- Capacity- -- ---------- ---- No�of compartments------- ----Size Z__J! ,-X --Liquid depth..... .......... . . ,• I t '� '� un I ------Distance to nearest lot line._�r_-.-_______ P - �-Z�Z -- ---r---W idth of trench_---�------------ ----.--•- - ;r-, _ _ ` _ !y 1 _ r_.-------- Number __.__ Dis o Field: ID�lluma47ee ofolines.earest w�-��-__---��g�h of each lin+ea'al�1-�__._---__.Total�length__�� -.�-�-/------------- ,Type of filter material_____- ------..__Depth,of filter ma Seep e Pit: Distance to nearest well_____.-�00�_ _Distance from foundation__/C_/_�___:=_.Distance to nearest lot liner _�_____.__ Number of pits----_�- g n- --------31- -=--.Depth.._ _ ] Distance #earn nearest well__�I�In_.__�Distance from foundation iameter--- Lining"matelrial---______________ - Cesspool: -Li Liquid Capacity gals. ❑ Size: Diameter.---- rest well - Depth q P Y --- ------------------- 5 ! ------.-Distance from nearest building --------------------------=--------- Priv Distance from nee ------------------- ------------ - - x = ---------------------- ------- Distance to nearest lot ine__._______________ ___" r � I. ------- F Remodelin and/or repairing --------------------- --------•------------------A------ ----------------------------------=--- -------- ' ------------------------------------- --------- - - --- --------- - ---------------------------------------------------"-------------------•------------------------------------"--------- hereby that } h ave pr dthis soland that the will be done n acc�ordance with San Joaquin County ordinances, tate wsand ulesandegulafonf the San Joaquin Local Health District. tn r Contract (Signed]_ _ {r -------(Tit e)---- - ------ By:. �"� '� ----- --------- (Plot plan, showing size of lot, location of system in r ation to wells, buildings, etc., can be placed on reverse side]. FOR DEPARTMENT USE ONLY i ! � � ------------ ---------- ----- DATE.-------- _��' . ----------------- APPLICATION ACCEPTED BY____._ ----------- REVIEWEDBY-------------------------------- ---------------------------------------------- ----------- ----------- DAT t --- ---- - - - - DATE._ - -------- --------------------------------•-•---- BUILDING PERMIT ISSUED------------------------------ Alterations and/or recommendations: _ __ ��' . - --- - ---- - - __..___"_____________________________________________________________ ________________________________ } /� ------- FINAL INSPECTIONy BY:----- -- ! `�. ----- Date------------ SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Ha:eUon Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California r Lodi,California Manteca,California Tracyr California