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APPLICATION FOR SANITATION PERMIT Permit No. ....�7.�e&- (Complete in Duplicate) Date Issued ---._ __3P1516 Applica-ion 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 Or 'nance No. 549. . ADDRESS AND LOCATION----- -..✓--- --•---�----C -- -------�'' ----------------------------------------- t -------------------------- Owner's --------- JOB A Q ss-- �� / � -- - �.? tel.! '-----# , Owner's Name------------ ---------- - -- ------- - -----•----- ------ -------- -------------------------------------------- Phone------------------------------------ Address_ ' '`� -,r............d . 'fit ={ � - ----------------- -• ; G`� Contractor's Name f' A- --- Installation will serve: Residence v 1�fs [jk-Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ---�_ Number of bedrooms -3.. Number of baths _4I-_ Lot size .._____ _ c ? _ .� [l ------- ter Supply: Public system Community system ❑ Private [s}�"epth to Water Table A WaY ❑ Y Y Character of soil to a depth of 3 feet: Sand ❑ Gravel F1 Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe -] Hardpan ❑ Previous Application Made: Yes E] No New Construction: Yes ❑ No a---" TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Sep , _._.Material________..__.__.__..._-_._..__..____.__.________. - No. of compartments--- ------------------ Size-------------------------------Liquid dept%----------- ------------Capacity.......------------ Dis I Id,: Distance from nearest well.-..5V Distance from foundation.�...., w"57-----Distance to nearest lot line.....A?-': I Number of lines----- --------------------------Length of each line-___Abk_ '_ Width of trench...-vZ--'X�------------------- 4- A-It Type of filter material- ._ e! Depth of filter material--- length .___.. _._._.S __.''.................. r Seepage Pit: Distance to nearest well____.____la_�Distanc�f�r��o� m foundation----r_,�'____'�...Distance to nearest lot line__- �'` Number of pits._-.1-.__ ------.__-Lining material_1 U`5--_ Size: Diameter-.J-6........_...Depth____ .-,r............. Cesspool: Distance from nearest well-----------------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--------------------------------------------------------------------------------------------------------------------------------------------- Remodelingand/or repairing (describe):------------------------------------------------------------------------•-•-•-••-----------•••-. ••-----•-••-----•--•--••-•-•-•-------•••-••--•---•-•... 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. DAY&NIGHT Contractor) (Signed) - ..............-Septic.Tonk-Service-------------- 1206 ---- -• -- 1206 So. Eldorado HO 2.7046 i # Title " By:------ .,' -- p�..+.,� i;.kfoii--Ca (Plot plan, showing size of lot, locaffl n of sys em in relation wells, buildings,YC., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-_ -•__-_ DATE-�____._._____ ---------------------------------I------- REVIEWEDBY ------ DATE-_-&--------------------------------------------------- BUILDINGPERMIT ISSUED---------------------------------------•------------------------------------------------------------- DATE......R/N--------------------------------- --------------- 1) 9-- Alterations and or re m end io s _______________ _ ___________ __ ............. --------------- ----------------------------------- --------------------------------------- ............... .............................................. -------------•-------------------------------------------------------------------- FINAL INSPECTION BY:.----- -.- Date... ":.. ---5 ---------------------------- 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 ATWOOD 12-54