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<C �"d � f APPLICATION FOR SANITATION PERMIT Permit No. 1_3__2-- . _►�3" (Complete in Duplicate) s �I � - Date Issued //oThis Permit Expires 1 Year From Date Issued pp an the e}iy made foie San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordi ce No. 549. yt c- \JOB ADDRESS LOCATION.-- 40 ra-ed� ---------- ------\_--_,W_,,---------------------------------- Owner's - 1 0. _ - ---------------•- Owner's -----0--1- ��C?_411a_611–S Address--------------------------------------------------- --------------------- --------- ------- ............ Contractor's Name_:_T__h - _-...--M........ _A_ '"rP ----- -- c '-----------------•--------•----------------------- Phone--- JCS Installation will serve: Residence M Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ /f Number of living units: _-_-�-_ Number of bedrooms _�-- Number of baths ___�__ Lot size -_- -_-�__�__�_._.__X_____�.l_--_------- � s Wafer Supply: Public system Community system ❑ Private ❑ Depth to Water Table ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe Ix Hardpan ❑ Previous Application Made: Yes ❑ NoX New Construction: Yes X_No ❑ FNA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 240 feet.) ` l Septic Tank: Distance from nearest we -�k��t4'_----Distance from fo dation__.-�`-0_--_-__-_.Mater' i No, of compartments___ __ ----------------Size-14 _____Liquid depth-------11--S-12____Capacity__.___C� OQ I Disposal Field: Distance from nearest well__—0.11C__Distance from foundation---!-0.........Distance to nearest lot line._-- Number of lines_______--1_____________________ __Length of each line_-@___-_ _____.__ Width of trench___.___ ______- y" r------------•-- Type of filter material __- _�_ Depth of filter material_____ _.__-_____.Total length___.-__.__ ___ Seepage Pit: Distance to nearest well_�A! _e______Distance from foundation---1_G�_1__-__-.Distance to nearest lot line___-K ..r Number of pits_.,__________________Lining maferial__RoJ ------- Size: Diameter-__,S*3. _..._-_Depth -..___s` 4-7-- ______--_- ,R Cesspool: Distance from nearest well-----------------Distance from foundation___-----------------Lining material__.______---_____.________- -- ❑ Size: Diameter--------------------------------------Depth'3_.---------- -----------------------------..Liquid Capacity-- -----------------------..gals. Privy: Distance from nearest well------------------------------------_-------------Distance from nearest building____.:. ___---_-________________--__--- - ❑ Distance to nearestlot line-------------------------- .-------------------------------- `Remodeling and/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, rules and regulations of the San Joaquin Local Health District, (Signed) -----24--&-1119 -— 19 --------------------------- ---------- - =-----------------------------------------fly *r Contractor BY V SEFrnCA,..TANK SERVIOM �1�C LstffG�/4�er�.w RV: d�FA ----- -- ------------ -----------(TT(Title) -- ---------------... (Plot plan, showing size of lot, location of system in r ion to wells, buildings etc., can be placed on reverse side). y I OR 9EPARTMENT USE ONLY k APPLICATION ACCEPTED BY---------------"`-- - - ------ ------------------------------------- DATE------- ---------------- REVIEREVIEWED --------------- WED BY----------------------------------------------------------------------------------------------------------- --------•-._ DATE----------- ---------------------- BUILDING PERMIT ISSUED------------------------------------------------------------------------- --------------------------- DATE------- Alteratioan /or recommendations:-------------------------------------------- -------------------------------------I--------.------------------------------------------------------------------ --------------- ----------------- -------------- -------------------------------------- - -------------------------=----------------------- ----------------------- ---------- - --- ------ FINAL INSPECTION BY• ----------- -=- - --`-=------------ -------•-- ------------ Date-- I ate- t "SAN JOAQUIN LOCAL HEALTH DISTRICT / �. 130 South American Street 300 Westx Oak S+;eof '132.Sycamore Street kt.�, ��`f 814 North "C' Street Stockton, California -Lodi, California Manteca, California c:,rt Tracy, California ES-9-2M Revised 8-'59 r.P.Co.