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APPLICATION FOR SANITATION PERMIT I . Permit No. ..�-!_�L'-• (Complete in Duplicate) a r Date Issued ._7/_� . - •-- 4 N, n d • ' Joaquin Local Health District for a permit to construct and install the work herein described. Application 1s hereby m�de to the San Joaq �_,.. This application 1s macfer'11 compliance with County Ord;n 549. J- ` ............ JOB ADDRESS A L CATION__..,--�-- L YL i� . 9 __�`s-. Phone............... ---••--- ,{ Ownera Name--,-�4_-- - _ / Ads,; • ••--•----•- --... Contractor's Nam - - Apartment House [ICommercial C] Trailer Court C] Motel ❑ Other �] Installation will serve: Res; ene-e 10p Number of living units: -__-_--_ Number of bedrooms "7:7 Number of aths -------- Lot size Water Supply: Public system ❑ Community system ❑ Private Depth to Water Table ft. Character of soil to a depth of 3 feet: Sand ravel ❑ Sandy Loam❑ Clay Loam.❑ Clay Adobe O''fi'i-ardpan Q Previous Application Made: Yes ❑ No New Construction: Yes o ❑ FHA/VA: Yes ❑ No TYPE OF INSTALLATION AND SPECIFICATIONS: (No-septic tank or'cesspool permitted if ublic sewer is available within 200 feet.) r 0_Distan f�r�m to ndat' n ----------- S Distance from nearest welly T -_Liquid depth_.. �n-- --• Capacity�+t!.- . No. of compartmen#s__ Size• ` Q-- Distance to nearest lot I�e Disposal Fi d: Distance from ne st weld __. ____-__ Distance from foundatign �w Length of each line_._ ___ -- -.Width of trench:"Z�- Number of lines-- ____- ,- g '. .Total length QQ ' !ef •_ Type of filter material..__ ______---- Depth of filter material__> -_-- 9 f Seepage t: Distance to nearest well>_�: :___...Distance m c undation_I__ ® D, to nearest lot line yco Number of pits--- __---------Lining material,' -__-- ---- Size: Diameter--- ---------.Depth_cr _a'y ---- Cesspool: Distance from nearest well.._____-_ ___--.Distance fro foundation Lining material___ quid Caciygals. 171 Size: Diameter__ --_-- ----- -- --• -- .. .... L - .. ____ ,Distance from nearest building Privy: Distance from nearest well_.------------ ........................ Distance to nearest lot line__.-__. - Remo ling and/or repairing (describe)..____--- stx5�+ - -- 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 n Joaquin Lo' Healt nct. (SignedW (Owner and/or Contractor) By:....-- ----------------•--••---------•--- -- ----------- - (rtle} --------------------------------------- By: ., .--•----- - ---- (Plot plan, showing size of lot, locatio system in relation to weK, buildings, etc., can be placed on reverse side}. FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY -- ------- .. DATE ._..... -• REVIEWED BY .---- - - DATE BUILDING PERMIT ISSUED-----------. ---- ---------- - DATE ----- • - `••�y Alterations and/or recommendations ........... ._... J.�. _4 ------ .eta ! pp __tyom �J� _.._S!slT.la.._ G?"D_.�-�-----,Q1,.t'.T.Xi2�•t�.a ... .•_....... �lu/ ea��1,5JCC _c �d.t---_- V -• Lisa3w�. /'� T v Nc� 2 PA Pc�l2 Date_--------_---- - —��`"�. ``�" FINAL INSPECTION BY:- ------------- ��—7 AlrS r/� 'd AN JO QUIN LOCAL HEALTH DISTRICT � 132 Sycamore Street . 814 North "C" Street 130 South American Street 300 West Oak Street Y 67 Stockton, California Lodi, California Manteca,California Tracy, California ES-9-2M , Revised 1.57 F.P.CO.