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FOR O.EICE USE: -. > APPLICATION FOR SANITATION PERMIT Permit No. -45:5-(S ... 4;;y (Complete in Duplicate) Datetlssued --•`�- ---• `_r" Its.---""_--___._.."_ j This Permit Expires 1 Year From Date Issued rYr; 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. S49. , JOB ADDRESS AND LOCATION------...2,3YJV-----Zth__ S'tj-----------------••-=� t f Phone . -358 ± ° ------------------------ ----- .. .HQ Owner ---•----•----------•----------•I y Address!.._'"_........... ` 3, ....••-• Phone... Contractor's Na'me_.._-W D01A4+...±S'el-?t C C,<1Z7 ' rU' 1? �r-----------------••---- j Apartment House El ❑ -Trailer Court ❑ Motel ❑ Other ❑ N_ Installation will"servei, R sidence [3A p i ,Z,-_. Number of bedrooms -2___ Number of baths ......L Lot size :;fiQ_._. .--11Q___________________________________ Number of living units: _ Water Supply: Public system ® Comy syst�m ❑ Private ❑ Depth to Water Table I.3 - ft. Character of soil to a depth of 3 feet: ISand ❑5 Gravel [I Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe Hardpan 4 r l � l No FHA/VA: Yes ❑ No [9 PreviousiApplicetion Made: (If yes,date_____________� ._ No�.M New Construction: Yes [ ❑ r TYPE 01F INSTALLATION AND SPECIFICATIONS.", , ' (No septic tank or cesspool permitted if public sewer is available within 200 feet.) p i ' e`from foundation___Z-Q'r-"-----.Material__.." _-._C_�n3e?�fr....-------••••------ SF"tic Tank: Distance from nearest well__-n0____-"__Distant ,.No. of compartment ----------------Size-.6'��'..............Liquid depth_J`'1.�..-- ------•.Capacity ..�pQ...--..-.-•. ' r 1 1.Y Disposal, Field: Distance from nearest well._.72Q---------Distance from foundationl_O ......=Distance to nearest lot line-•__.5 r-._.-. \ ® ` a, Number of lines------- ---- ----------------- -Length of each line--------'�Q 1--------------Width of trench------ -1------------------------ Type of filter mate l._._.�"Qgh-------- of filter matenaL Bj�----_---_.""Tdial �tength_..¢Q-1`•------ Seepage Pit: Distance to nearest well-110_------------_Distance from foundation___---- ?_!.___.Distance to nearest lot iine._,_ -M-.: .. Lining material_____-"i''OC €""--.Size: Diameter____.33-"�---____-Depth____ZY!.__Aq:x�••- ® Number of pits; ------------ + Cesspool• Distance from nearest well----------------- from foundation---------------- E] material_ ."______-.__-_"___... '_..`__.:= -.b.,.. . w-. --.-.! ----"-'---L'i quid Ca aci -------••-------------------gals. ❑ meter ------------ ---------------Depth 9 i Capacity Priv DI fence from nearest well.____._-".__._---.--""_--- •------------ ------Distance from nearest building--------------------------------•-------- y' ` ----------------•---------------- ❑ Distance to nearest lot line-------- . r Remodeling and/or repairing; (describe) r_ep�_a_g1 _g-.__C-arm?d_ l7L__-r.-ea Ji?Q_�_..u1�_�`�Z___7��1...�_s°171�n_�C_-.�`r0��ie `�. --------------- ` ----- --- _,and.._dr_ai.ri--- ----- -tank _ _ --- G `" .�. ` - -1 ....q - — .-- -- hereby,certify that-1,here-prepared this application and that th work i I be done in accordance�wifWSan Joaquin County in State laws, an rules and reg ations of the San Jo� iin ocai Health s °�-' �� f - -•-- �' � y -- '�' '''''(Owner and/or,Contractor) ,pt-�a_..T4ank_._�'�r�t;��-.-Ing•- (Signed-------- C t. C:-^-: J . ' _-:Title---G�n_._. R a;r h�a-n---•--------------------------------------------- - - , { 1 - �T (Plot plan, showing sizeof lot, loca4ion of system in relation to wells, buildings, e+c., can 'be placed on reverse aide�. FOR DEPARTMENT USE ONLYq t 1 -=---------- DATE.. 3-- APPLICATION ACCEPTED BY__---i_______ _____ _ REVIEVIED I3Y__... ----- DATE--{ ` -- -------------------------------------- BUILDING PERMIT ISSUED__.. -------------------- DXTE.--A----------- ••-------- ------------- Al+eratigp an or recommendations• ; -•----•-----•--•---•-- -- --------....-•--------•-------- ------------------------------------------------------------------------------- -------------------- --- ------------•----- FINAL INSPECTION BY-------------- - -----��-- ------ Date--------- ------ j `✓�--------------...--------- i SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak STreel 124 Sycamore Street 205 Weil 9th Street Stockton,California Lodi,California Manteca,California Tracy,California ES 9 RSVISEO 8-59 2M 9.61 ATLAS