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---- -- - ----- APALICATiON FOR SANITATION -- - --- PERMIT Permit No. j _ {Comple}e in Duplicate) - This Permit Ex ires 1 year From Date issued -•-- ___ Application is hereby made to the San Joaquin Local Health District for This *plication is made in compliance with County Ordinance No. 549. a permit to construct and Date Issued 77 install the work herein described. JOB Owner ADDRESS AND f' Name.--. p 1 ._. `-`-C ':..:....... ......•-----•----------------- 1.•� ------------- - -.C_ Address-----•• --- --------------------- Ph ----------•----• - one_ � L3 7 •-- . '!-- -- ----I-------- Contractor's Name----------------- Installation will serve: Residence ❑ Apartment House Commercial Number of living units: _•_-�-- ber of bedrooms - ❑ Trfiler Court ❑ Motel ❑ Other 0 Wafer Supply: Public system Number of baths -_--.--. Lot size _--_-- Y Community system ❑ .;Private ❑ Depth To Water Tables��f�� -�•�•1... � ��........... Cheracter of soil to a dap}It of 3 fee}: Send ❑ Gravel ❑ Sand oam Previous Application Made: (if yes,date----------- ---- ❑ Clay Loam [] Cla Adobe Hardpan [] TYPE OF INSTALLATION AND SPECIFICATIONS: } No New Construction: Yes 2 No Ej FHA/VA: Yes ❑ No (No septic tank or cesspool permitted if public $e 's available within 204 fee}. + Septic T Distance from nearest well____ ) Distance from foundation-_-/d--� - No. of compartments--- -------- M t rial-__A,-- _A9 P �� ----------------------- - •-----•-•-••---•..-----•---•---- Dis -------------- Disposal d; Size----_- ----- �( /( Liquid depth_-- -- p Distance from nearest well.. Capacity .@ C7 ..-Distance from foundation__._. - --.�-----Distance to nearest lot line.-.X".�__ Number of lines_____________ � -- _---__Length of each line---- Type of filter material._._ !!G ----Width of french-- ---Depth of filter material_._. ------•--•------•-••- Seepage i : Distance to near t elf --------- - -----Total length___- - or _--_._-___Distance from foundation--.,-/ / Number of its-_- istance to nearest t line•_____ , P Lining material_._YZJ-;-k---Size: Diameter ��_ Depth Cesspool: p ,� ❑p Distance from nearest well------..-__-.- Distance from foundation-------------- -----Lining material.-_-.--.-__.-- Size: Diameter-------------------------------------Dept h-------------------------------- ------------•-----.-.. Privy: Distance from nearest well------------------- ------------------•-Liquid Capacity --------------- •---•-------- gals. ❑ Distance to nearest lot line__ ____________ -------Distance from nearest building-_-----.-_,_______ ------------------•---- Remodeling and/or repairing (describe):-- :--?:-?---�--------------- ------- 'r_._.- ----•----•----- •------•--•-------------------- -------------•----•-•----------•--•-------------•----------- — ------•--•----------•----------------------•----•-•-------------------------------------------------------- ------•--• -------------------------- I hereby certify that 1 have pre is application and that the work will be done in accordance with San Joaquin County ordinances, State laws, a ru an a at' ns of the San Joaquin Local Health District. (Signed)---•------- ---- . . --.. ... By:..._._------._---.--• _ �---(Owner and/or Contractor) (Plot plan, showin size - -__-(Title)-- •-- __ 9 , Iota}ion of system in rel o wells, buildings, etc., can ba placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY---- J �,-L� REVIEWED BY---------- �L --.,----- DATE---- ------------ _-- --_BUILDING PERMIT ISSUED- - ----- DATEZZ �� ------------- --•-•------------•-••---•--•--•---••-----•.Alterations and/or reco rnen oi - --- ---- ns: -- _ - ..-. , ----- -------- FiNAL INSPECTION 8 / Date,(.-- r }30 South American streetSAN OAQUI LOCAL HEALTH DISTRICT Stockton,California 300 West Oak street 124 Sycarnors Street Lodi,California 205 West 9th Street ES 9 REVISED a-59 2M 5-62 ATLAS Manteca,California Tracy,California