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A4 , \ APPLICATION FOR"SANITATION PERMIT Permit No. ... ..... (Complete in Duplicate) Date Issued ../j.3. Application is hereby made to fhj San Joaquin Local Health District for a permit to construct and instal the work herein described. This application is made in compliance with Count d' ance� No. 549, n JOB ADDRESS ANL09ATI�O.N_74A `----- -- - -- -- _ ' ,.. s Owner's Name----- PhonAddress_.... _et +--• ---.._.. . z 1�__�_ r 1 Contractor's Name-- Phone, --------------- ------ -----•. ---•-•-- - -• •-- Installation will serve: RTidaac' Apartment House.-C]-- Comme I ❑ Trailer Court ❑y M�#el•. Other El Number of living ynits: __�_.__ umber of bedrooms Z. Numbed baths -__I.. Lot size _��_ \JC.�: _...: Water Supply: Public s Item Mo Community system ❑ Private ❑ bepth to Water Table ........ ft. Character of--soil to a de th of 3 feet:..:Sandndx.1� Cla Loam D Cla Adobe Hardpan Y ❑ 0 Previous Application Ma Yes ❑ No New Construction: Yes Y No ❑ FHA/VA:Yes ❑ N } TYPE OF INSTALLATIOP AND SPECIFICATIONS: (No septic tank or,cesspool permitted if ub jc sew r is available within 200 feet �� /o � ` Septic nk: Dista -from near t we)�'.Q_�.__.�_ ist r•#r�so�r .,foun .tion--------•---_------.Matte�ipl ----.•-r-••'•- -----•----•- ,,j._ ._...... No. of compartmer� Size �..t ---Liquid �eRt • '� Capacity.., Dispos Field: Distance fforn iiLar st3welf�?Q .Distance from foundafio ...� � istence to nearest lot in�e�/-�. t k --_____-- Length of each line___O..,! r. idth of trench .,-_.... _.`f" Num, er of )apes � r- `�" Type of filter m e" e- .. ----0�pth of filter material--.-•-.. Total length.,.._._..:.: � � ._ fes,.. Seepage Pit: Distance to newest well -__--_-_____-._-__Distance from foundation....................Distance to nearest lot line_.. ...... ❑ Number of pits_ _____ __Lining material-----------------------Size: Diameter...._ __._-___..___Depth Cesspool: Distance from nest*11.................Distance from foundation--------------.-_.Lining materiel El Size: Diameter- -- ---- `------ ------Depth------•---------- ----- -- --••- -----•----Liquid Capacity........... ......-_.......gals. Privy: Distance from arest well-________.____________._-__________________Distance from nearest building......................................... 31 ❑ Distance to nearest lot lihe--•----- - -- ----------- ------ --------------------- - ..........................................-_, ...._.. . ... .__. el Remod g&d or re a ri g da tibe) a ......................-------------------------------�� ---------------- ----------------------------------•-----------------..............................................••---,...... -------•.. .x------- ------------------------------------------------------- ---- ----------------------------- --------------------- ------- --------------•----------------------------- ---•-----------•---------------- --------- -•--- ....... ..,.. I hereby certify that I haveprepared tl"is application and that the work will be done in accordance with San Joaquin ordinances, State laws, and rules acid regullns of the San Joaquin Local Health District. (Signed) �'-*� Owner and/or Contractor ----- ------ ---- -----•--- --------------------------------------------------- (Plot plan, sh ng size o` lot, location of system in &tiono wells, buildings, etc., can beplaced on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY _. -.._........ DATE=:'_"'.•---_-__ _ REVIEWED BY --------- DATE •---------- ------------------ ----- - BUILDI G P RMIT IS ED----- - --------------------------------•------------------------------------- DATE,.--- ------------- ----- ----- - Alter ions nd/or m ns ------------------ ---- •.._._ ...- ... 142/ - -- -- - --- ace l ' ...__. FI iNSPECTI N B -- ---- --------------- Date -._.... --••----/ .......................f 130 South American Street 300 West Oa treat 132 Sycamore Street 814 Nerth"G'Street Stockton, California Lodi, California Manteca, California Tracy, California 7 ES-9-2M : Revised 1.57 F.RCO.