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FOROFFICE USE: I i:"7 -- --------------- ------- v lq : 1(r 135 i7 _I—-.•----- --- - - -- - r - - APPLICATION FL.., SANITATION PERMIT Permit No. ._.. .... f t ------------------ (Complete in Duplicate) F � Date Issued .:�f: �_'3------ ------------------- ------------------------ ----------- This Permit Expires 1 Year From Date Issued Applicafiion is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. l This application is made in compliance with County Ordinance No. 549. r . F JOB ADDRESS AND. LOCATION-----------------3325_ Phelphs---_------•- I Owner's Name = Da,lmcZc�o- Dt��Ay--------------• Phone �iQa._._?�-g�2�-... . -----•---------------------- ---------------- --------------- Address------------------ -- ------AbQ-V-e----------- - Contractor's Name----------DE . "��Pc._ IkSSS'STB----------------------------------- -PhoneHQ.«---3-1269 tInstallation will serve: Residence ® Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ...I_ Number of bedrooms __.-3__ Number of baths .l._. Lot size ___75 t-tlOQ t r ! Wafer Supply: Public system 91 ' Community system I] Private ❑ Depth to Water Table ___35 it. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe [2f Hardpan ❑ Previous Application Made: (If yes,date------------_-----) No E) New Construction: Yes ® No ❑ FHA/VA: Yes ❑ No TYPE OF INSTALI ATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 204 feet.) Septic Tank: Distance from nearest well-_210ne-__Distance from foundation__1.0 t________Material ® Mate ial____Cement-----------------_-------_ No. of com artments___-_2------------------Siz X4A -- --------__ -. -4---•--- qp -.---- 2- Capacity-----8QQ..Gal , Disposal Field: Distance from nearest well________________Distance from foundation--------------------Distance to nearest lot line----------------- ❑ Number of lines-----------------------------------Length of each line----:-----------•-------------Width of french---,------------------------------- Type of filter material--------------------------Depth of filter material-----------------------Total length-----------------=------------------------ C'il Seepage Pit: Distance to nearest well-------hone. -Distance from foundation 1.�_s_________.Dista--------- a to nearest lot _ine_------�__f Number of pits-------1----------.-Lining material_____X'OCk_.__.Size: Diameter--------3311-------Depth---25-t___ZaX.------- Cesspool: ____.-Cesspool: Distance from nearest well---------------__Distance from foundation--------------------Lining material__._.___-__._________________________. J ❑ Size: Diameter--------------------------------------De th----•--------------- ------ - --------------Liuid Capacity_ Privy: Distance from nearest well-----------------------------------------------_Distance from nearest building_______-_______________-______._______- 1 ❑ Distance to nearest lot line.-----------•------------------------- -.... i Remodeling and/or repairing (describe)--------TAP 1;3.3.1!PZ-----Y1eW...5 4.x.0.--t,nkD- d_Y-11t_ar-'_bad----C_-UaIng. { ----- a i_8 ink 1 Clea -------------------------- ------------------------------------------•-----•-•-•-•----------------------•------------------••--------------- •------•-------•----------------------------------•------------------------------------- .y -------------------------------------------------------------------- -------••-------- ---------------------------------•-•----------------••-------------•--------------------------•----•------------- ---- - 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) Tank. 6rVICe.r-...I2gq----------------------'-- "---------------- (Owner and/or Contractor) BY:-----------•----•------------Perry Warthan {rtlel--- Gey..- --Ngrz' ------------------------------------------- - - -------------- - -- - ----------------------------------- (Plot plan, showing size of lot, location of system in relation to wells, buildings, efc., can be placed on reverse side). f ' ) FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-------------------- -- --------- --- -------- DATE �. REVIEWED BY - ---•--------------------- DATE - BUILDING PERMIT ISSUED --------- -- ----------------------------- ------ DATE = ':=-'= � Alterations and/or recommendations------------------- �'_ _ -- �•---------- --•---------------------- --- - ----------•---•-.-•---- ----- ---- ---- ----------- � -- ----- --- ---- _ -,c ----- -- ---�'------�-�_-.fir -----•----- ---�•�c------ ---- _ ` �----� - ---�' S--------------- --------- t-'zitie 0 K c � 5 FINAL INSPECTION BY:----0 ..... -------------------- Date__.A- SAN JOAQUIN LOCAL HEALTH DISTRICT F 130 South American Street 300 West Oak Street 124 Sycamore Street 205 Wos+9th Street Stockton,California Lodi,California Manteca,California Tracy,California EB-9 PCWOEO 9.39 F.P.LO,SM 0.60 i