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FOR OFFICE SE: J t, =---- l�a�i -----LLS _3 APPLICATION FOR SANITATION PERMIT Permit -------------------All ------ --- --- (Complete in Duplicate) Date This Permit Expires 1 Year From Date Issued Date Issued ._..y._.6/ 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...-- --------------------------------------•--•--------...-------------------------•------• Owner's Name --------------------Qe.a ge..Ralmchl------------------•-----------------•-------------•---•--•-•---------------•----------._. Phone.... HQ...58996--------- Address............................... ISame----------------------------------------------------------------------------------------------------------------------- --------------------•---------------------.--- Contractor's Name-_ Th.._DAY--&--R?IGHT....S.•---T-e---SvC..-----------------------•--------------•-•-----•------.......... Phone .... PQ....63BY1.------- Installation will serve: Residence (I Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: .1--- Number of bedrooms ---- 3. Number of baths .....1 Lot size ........ 65! ... $..1.5fit__--_--------------- Water Supply: Public system ❑ Community system ❑ PrivateX] Depth to Water Ta66eQ------- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe]Hardpan ❑ 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 200 feet.) Septic Tank: Distance from nearest well-________________ Distance from foundation .................... Material ----------------------------------- _............. Exiting No. of compartments ---------•-------_------ Size -------------------------------- Liquid depth -------------------------- Capacity ...... ................ Disposal Field: Distance from nearest well __.7.0.! ------ Distance from foundation -___---50.1 ----- Distance to nearest lot line ... 5 ......... ExI19ting Number of lines ......... .1. ----------- _---------- Length of each line ----- 20t -------- _-------- Width of french ------ 2i+_r,..................... & Add Type of filter mate ria l_.t$_ePt0__.RkDepth of filter material ------- xal-________Total length ...... 2.Q..f%.a............... Seepage Pit: Distance to nearest well_1QQt--------- Distance from Distancefoundation ------- 7.Qt.._..to nearest lot line ..____.150_% o\ ._.._.__. .............® Number of pits -------- �----------- Lining material___ Rack ------- Size: Diameter ----- 33___Depth_.__..25..... N Cesspool: Distance from nearest well ----------------- Distance from foundation -------------------- Lining material. -______-__-----_-_--__.._---_--_---_ ❑ Size: Diameter -------------------------------------- Depth _--------------- -----------------------------------Liquid Capacity ----------------------------9 1 _ Privy: Distance from nearest well ------------------------------------------------- Distance from nearest building _-.-.-_..._...______._.__-.___-_---_____: ❑ Distance to nearest lot line ----------------------------------------------------------------------- ---------------_-------------............................ ---------- Remodelingand/or repairing (describe):-------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------- r -PP7. M-llARY-_-I?AASlIA GE---------------------------------------------------------------------------------- -----------------------------------------------------------------------------------------•-------------•-------------------------------•- ----------------------------------------------------------------------------------- ---------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------ 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)-`T.he --- Day- --- kNight--- 3.0P__-tiC---- -ank_'�' C• l Contractor) --------------------------- By: ------------------------------------------------------------------------------------------------- -------- A ----•...------..(riitle)------------------------------------------------- -------------- (Plot plan, showing size of lot, location of system in relation tow , buildings, etc., can be placed on reverse side). ENT USE ONLY APPLICATION ACCEPTED BY ----- 1`%.:? _ ______":"(�'__ __________________ REVIEWEDBY --------------------------------------- ---------------------------------------- BUILDINGPERMIT ISSUED------------------------------------------------------------------_-------- Alterations and/or recommendatiohs----------------------------------------------------------------- -------------------- - - ---- ---- - -- ------ - - �: ------------�y L/ ---.ii--� — / ••. - --------�-- FINAL INSPECTION BY: 130 South American Street Stockton, California ES -9 REVISED 8.59 F.P.CD. 2M 6.60 -----------------•----- DATE----------- -------------------- ----------------------- DATE------------------------------------------------------------ --------------------- DATE ------------------------------------------------------------- .......................................................... -----------------------------------------------------------------------------------• -- ------------------------------ -• -- ---•-- - ---- ------------------------------------------------------------- Date------ - �_ . a C ---------- -------------- --------- -- JOAQUIN LOCAL HEALTH DISTRICT 300 West Oak Street 124 Sycamore Street 205 West 9th Street Lodi, California Manteca, California Tracy, California