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APPLICATION FOR SANITATION PERMIT (Complete in Duplicate) a 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 1206 North Funeto = ------------------------------------- ------------------------------------------- Owner's Name......4r=- and Mre' Frank_ Heffle { ------------------ Phone--6 _!~_+129----------------- 1206 North__Funeton----------------------------------------------------- ------------------ -- --------------- ---_--------------------- Del _ -------------------------------------------------------------- PHone-_ --3-933---------------- Contractor's Name-------------�a-------...-----------------••--- ------------------------ Installation will serve: Residence K] Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living.units: [I Number of bedrooms [a Number of baths 10 Lot size----50_-_X--1-50---------------------------------- r Water Supply: Public system [X Community system ❑ Private ❑ Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe;K] Hardpan ❑ ` TYPE OF INSTALLATION«AND SPECIFICATIONS: r i� (No septic tank or cesspool permitted if public sewer is available within 200'feet.) Septic Tarok: Distance from nearest well-----------------Distance from foundation____-___----_-------Material_----------------__---------- ___:_-_. aa1Ating No, of comps nts- ---rpt----�G-- _apac �--------------- - Size------•-------------------------Liquid depth----------------------- i Cesspool: f Distance from nearest well________ _____Distanqe from foundation___-----___---_----Lining material------------------------------------- ElSize: Diameter--------------------------------------Depth---------------------------------------------------- Privy: Distance from nearest well--------------------------------------------.----Distance from nearest building------------------------------------------- ❑ Distance to nearest lot line------------------------------------------------ , Seepage Pit: Distance to nearest well-_r'_--_-_-___Distance from foundation-A -------------Di tante to nearest lot linee_ -------- Number of pits-__c-1-------------Lining material--br,19k------Size: Diameter_--__.._�_a�.....Depth-___----____----_---.-�_-,-__ r Disposal Field: Distance from-nearest well------------Distance from foundation- .__----__-_�_-Distance to nearest lot Ii.e------=_.{r___-_ I [� Number of lines___-1.:'________________________Length of each line-_ - 42a-__.Width of trench-, --- ----. - --- --- Type of filter material.__2'QC4----------Depth of filter material---------- sf--:_--- Remodeling and/orirepairing (describe):- -------------------------rep:81 'ing------ .--------------•---- --------------------------------------------------------------------- ------------------------------------------------------------ N Y -------------------•- ----------------------------------------------------------- -----------------------------;------------ 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 cal Health District. [Signed)--------------Dela---5eptic___Ta11k ---- ------------. . - --- ------ ---------------------------------------------------------(Owner and/or Contractor) Perr War than i [ 1 Owner�Mgr•------------------------------ BY�•-••---•---•••--•---y -----r � Title (Plot plans, showing size of lot,Iota+ion o syste m son to Viells, buildings, a+c., must be filed with this application). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY------------------ ' ---�---:---------------------------- DATE / � v`s3 ------------------ DATE-------------`-;,��------'-------------------------------- REVIEWED BY---•------------------------•------------------- --=---------------------- ----:---------------------- ,�..� BUILDINGPERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE---------------:--------------------------------------------- Alterations and/or recommendations:------------------------- ---------------•--------------------------•----------------------------------:-------------- 1=-----------------------------'- e ------------ ------- ---------------------------- -- -- 4 ----------------------------------- I ------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------- ---------------- P.ERMIT No. -A..--- ISSUED �"Z (Date) FINAL INSPECTION BY:-- �---�----f y�---`�`-/--------------------- Date----------------------- G-- -----f -- -------------------------------- W SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street , Stockton, California ;- - ES--9-2M 9-50 W=1639 ,