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� -- APPLICATION FOR SANITATION PERMIT Permit No. .-.1... (Complete in. ate Issued , Duplicate) 3 ��.-r..•��.,�•,..., +' � .�....,,M _ - -- ----- < ---•------ D / SZ Appiica+-ion'is hereby made' to the SanJoaquinLocal Health District for a permit to construct and install the work herein described. This application is made in compliance(with County Ordinance No. 549- 1816 Ee 8t JOB FADDRESS AND LOCATION------------------------------�`----- -• Stockton t ( r.:•iioriaF) . Federal Home Insulation Co Owner's.Name - - = - ---------•------------------------------------------------------------ --------------- - '-----'------ - ---='--- Phone---W-'--665--�-n-------•-•-- Address---........ 122 - -CIm>•Qh xeetR -------------•-------------------•------------------------------- -• ---------•---------------•---•--- Contractor's Name-••=-•-_:DAY & NIGHT SEN1C TANK SM. -------------•-----------------------•------------------ ------------------------------------ Phone.-HO 27046 Installation will serve: Residence ® *Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ " Number of living units: _.I* Number of bedrooms _Z*_._ Number of baths 11!___ Lot.size ---MX150 ______•____-_-____-_-____________-_ Watef„Supply: "Public system ® Community system ❑ Private ❑ Depth to Water Table 401 ff. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam❑ Clay ❑ Adobe Q Hardpan ❑ Previous Application Made: Yes ❑ No [I New Construction: Yes ]* No ❑ I . TYPE-OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Disfance from nearest:well-.;FQA0*_-Distance from foundation------a4!-------Material------CC_.aartok [� No. of compartments. _Z------- ------ ---Size__51 7XW6 x ---Liquid depth---_'__ ' ' Capacity 940 ---------- Disposal Field: tenearest well_N9ne*._.:D+stancfrom foundation_ 5t -.-__-_--.D•stance to nearest lot line1{ r --- -_ ______Nunbeoi lines '-__- --------------------------Length of each line---- Ut-------------------Width of trench-------4rr ( 'Type of filter material-*@.P.__M*__._Depth of filter. material--_-18'i__._.-_-_--Total length------- -- Seepage Pit: Distance to nearest well------ ope* ':Distance from foundation---I2_. _.._.-Distance to nearest lot line-__ © ® Number of pits. _-- ,; ..-'4-.___Lining material-_._Br ck_____-Size: Diameter.-..-:48"__-. Depth-.._._--------------------------- Cesspool... --.a��- �i i -- - ---------- p Cesspool... � Distance from.nearest well-------------------Distance,from foundation------------------- Lining material---.--_-.---___-------__-_____--____ ❑ "R Size: Diameter---=-- ----t ----------------------Depth- --`-`-------------------------------------- ------Liquid Capacity-------------- gals. Privy: Distance from nearest well--------------------------------------------------Distance from nearest building--__.________._____ Distance to nearest lot line...........:...."____- --------'-------- f Remodeling and/or repairing (describe):-------*-'-ail- on__Paremfses__not- in use-�----to---be--- and 0 PPea b7-------- ownere House located- in Prom- of_dwelliz� to be served Py tis disposal system will is �erYQcl:_by mutual__drain_•pool___o __ xi sng septic tank'-------------------------------------------------------- ------------------------ t& -- --- ---------------------------- ----------------------------- -•------------- -- -------------------- ---------------------------------••--------------------------------• ----------------------------•- ------------ I 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 rules and regulations of the San Joaquin Local Health District. (Signed)-- — -AIR.. - 51 E$.-- 6--- (��Contractor) # Partne r By:--------------•--------•----- ------ c ------- --------- --------------------------------- -----(Title)----•----------- - (Plot plan, sho in size of lot, location of system in relat n to wells, buildings, etc., can be placed on reverse side). a FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY--_ �'' DATE - -------------------------------- ------- ••--------.- 1 f ------•---•-- ------------------------------------- REVIEWED BY . - ----- ---- ' DATE----- ------ BUILDING PERMIT ISSUED---------------- ' ' `sr' DATE Alterations and/or recommendations:--- - ------r.- �' ' ' ... ± •--------•-----------e? ------••--------.. r� r° a - a -- --- ' - -------? - r W / ------------------- 'lie _- ------- -- F FINAL INSPECTION' BY:_. -° _ Date.. V.. _-'- ----------------------- ----- - SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C” Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9--2M 145446 ATWCUD 12-54