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' �OR'OFFICE USE: y. f ________ __ ____ __ r t' o APPLICATION FOR SANITATION PERMIT Permit No. { {l - (Complete in Duplicate) -------- - - --- This Permit Expires 1 Year From Date Issued Date Issued 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. JOB ADDRESS AND LOCATION------------------2.3 35.-North__"1F11Steet, tor --Sc ton----- Owner's Name------------------------------------------------•--E. A. POPE ------------------------------------------- Phone.__._46Z-571.3---•-------- Address--------------------------- Sme ---------------------------------------------------------------------------------------------------------------------------------------- Contractor's Name...---_ThE--DAY--&----IIGH`-----�-pt c--Tank Service Phone__466e»3849-------------- ----------------------- Installation will serve: Residence ;T Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: -1----- Number of bedrooms ---Z__ Number, of baths _-_1_ Lot size -------75 x---1-5Qt----------------------------- Water _______________________ ___Water Supply: Public system 4X Community system ❑ Private ❑ Depth to Water Table _6.0__ ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay C3 Adobelg Hardpan ❑ Previous Application Made: (If yes,date------ --- ---------) No ❑ New Construction: Yes E] No FHA/VA: Yes ❑ No E] TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest w61.____N0M0—---Distance from foundation-------_1-0'1-----Material---Gonc `eie--------------------- No. of compartments--.-.----2--------------Size3-1--- ----9-t--x62n--Liquid depth_-561-----------------Capacity---- Disposal Field: Distance from nearest well- None_-__Distance from foundation---1fl�____------Distance to nearest lot line-----6 ------- Number of lines---------1-------------------------Length of each line---9Qt--------------------Width of french--------211,11------- Type of filter material---Sept-.Rk-----Depth-of filter materiaf----1.9n------------Total length------------------go! _____-----____.__ W Seepage Pit: Distance to nearest well.__NflAe--------Distance from foundation------:2 :T......Distance to nearest lot line-----6_z'--_-.._ W Number of Pits-------_T_-----_------Lining material---R4Ck----------Size: Diameter------3311---------Depth--------------2 Cesspool: Distance from nearest wefi-------------_---Distance from foundation._-____-____.:------Lining material------------------- ❑ Size: Diameter--------------------------- --- ------Depth--------------------------- Liquid Capacity gals. Privy: Distance from nearest well__-------------------------------------- .._..Distance from nearest building---- ------- ❑ Distance to nearest lot line-------------------- RemodeSing''and/or repairing (describe:---# gfyia-c _-$sting-_---cesspGGJ--and--divier,tiag--1$=dr7-,room--I Ine-. I from•existing-_well-_pit_-ta_tne-_ne,r__septU__ ank-_syAtem,..------------------------- ------------------------------------------- -- ------------------------------ -------------- - -- _ -- - - - - -- -- - _ --- -------- ------- ---- -------------------- ---- - --------- ------------------------------------------------------ - -- I hereby certify tha have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, rules and regulations of the San Joaquin Local Health District, (Signed) - SEPTIC TANK--SERVICE------------- ------ ----- - - ----- ----------------- 6_ IOwner 2915E Miner Ave • JHO 3841 gr �------------ ----- -------------- - e}.- (Plot plan, showing size of lot, location of system in rel i n to wells, building etc., can be placed on reverse side). t FO DEPARTMENT USE ONLY APPLICATION ACCEPTED BY- ----------- ------ - DATE----- � REVIEWEDBY---------------------------------------------- -------------- DATE BUILDING PERMIT ISSUED------- -------------- - ---- DATE Alterations and/or recommendationsl ------- --- - ------- -------------------------------------- ------ ------------------------------------------------------------------------------------------------------------ ---------------- ----- ----------I--------•-------------------------� -------- - ------ ----------------- ------------- ------------------ - ------------ l FINAL INSPECTION BY:..... �----------------------------------------- Date------------- bra SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy, California c F.P.C o.