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APPLICATION FOR SANITATION PERMIT Permit No. _____ -D___57__ _8_ (Complete in Duplicate) Date Issued 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__•.__�-------_3_936_._Section Ave., Stockton 1 Owner's Name--------------L.__--F�--.---V1LKERSON. ------------------------------------ Phone_ H0 22tf63 Address---------- Same --------------------------------------------------I-------------------------------------------------------------------------- I Contractor's Name------------DAY___&_NIGHT _SEPTIC TANK SERVICE. HO 2rfo4b -------------------------------------------------- ------------------------------- Phone------ Installation will serve: Residence Ex Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: __l--- Number.of bedrooms 2_ Number of baths I___- Lot size ______L20-�-- --�--- - ------------------•------- Water Supply: Public systemX$ Community system E] Private El Depth to W'ater.,Table -------- ft. Character of soil to a depth of 3 feet: Sand 0. -Gravel []—Sandy—Loam ❑Clay.Loam ❑ Clay ❑ Adobe ZK Hardpan ❑__ Previous Application Made: Yes ❑ ' No ❑ New Construdtion. Yes ❑ No X] FHA/VA: Yes ❑ No ❑ Replacing TYPE OF INSTALLATION AND SPECIFICATIONS: I A^ I Septic Tank (Na septic tank or'cesspool p#rmitted iflpublic server is available within 200 feet.) �. Septic Tank: Distance from nearest well'__A2_Distance from foundation_ ____ __0CC - - --------.Material--------- --=-$r-----ACk---•----- --••-- XJ No. of compartments----2_•.---------------Size__56 7_X3_?_--__X_.-__Liquid depth_-56"----------------Capacity----$QQ__Gx31 S W Disposal Field: Distance from nearest well-----------------DistanOfr'om foundation____.______________Distance to nearest lot line----------------- X1,9 Number of lines-----•---------------------_-,--Len o ' E �.St'�rig • ' th 4� f:each line----------------------_-------Width of trench__'r_ W a _ Type o filter material--------------- ----------Depth of filter' material----------------------- -Total length----- ------------------------ Seepage Pit: Distance to nearest well --------------------Distance _------ 6 p gfrom foundation__ -____.Distance to nearest lot line________________ Eff StIng Number of pits—r------------------Lining material- Size: Diameter----- ----------------.Depth-- -- ------ l V ' Cesspool: Distance from nearest well=x-•____.--__.'_`Distance from,foundation�/_------ --_.Lining material----- _ ---------------------------- El Size: Diameter------------------ j. .Depth -rr +' Liquid Capacity gals. - ------------- --------- Privy: Distance from nearest we ------- - _Dist e from nearest building F ' ❑ Distance to nearest lot line_____ ____ ).__._ �� l 0 t 1 Remodeling and/or repairing (describe):____-_--l.R-e'_pla_C ng---eXjSt:jpg Septic Tank to enable addition --�D------wit...back---Core --------- --� # �_:_ - k -------------------------------- - - -'----------------- --------------------------------------------------- -I , ! hereby certify that I have prep --- ---------=------- --------------------------------------------------------------------------- ------ ared this appli ti n a that t e work wil be done in accordance with San Joaquin Counfy ordinances, State laws, and rules and regulations o A S n Joaqui Loca H If District. i (Signed) DAY & NIGHT SEPTIC TANK S VIC . . . . -- - ---- - ----------------------- _... (O� Contractor) By:-------------------------------------------------------- ------------- -- --- =------- -----(Title)------------------- ----------------------------------------- (Plot plan, showing size of lot, location of system i r lation t wells, buildings, c., can be placed on reverse side). t I R DEPARTMENT USE O Y APPLICATION ACCEPTED BY-�__._ __ - ---------- --- ---------------------------------------------------------- DATE 4 REVIEWED BY ---------- ----------------------- DATE - .----- ---- _ ------------------------------- UILDING PERMIT ISSUED---------------------------- - -------------- - ------------- D TE-----��-----•----------------------------- - - ------------------------------------ -- Alterations and/or recommendations:____________-__----_._ -_ - =-- --- -- I{ - ----------------- c ------ l ri {~d `------------ ----------------- ---------n�'--------— ---- -'�^1 pn` 5 _ ........_----------------------------------------------------------------------_------__ � � FINAL INSPECTION BY:. --- - - _ --- Date i.�_o l - ------- - ------ SAN ----SAN JOAQUIN LOCAL HEALTH DISTRICT I 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 Revisea 1.57 F.P.CO.