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1Aj APPLICATION FOR SANITATION PERMIT Permit No. .-(_..,1..�.. (Complete in Duplicate) �Jy Date Issued ----- -----71S-4- Applica4ion 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....---1+25-.w-.__7th. Stockton - - --- --- -- --------------------------------------------------------------------------------------------- I'S ._- .-- J Di`IZ.0 ------- Phone------------- -------------------- Address ------------------ Owners Name--------- .�-- ..�---------------------------------•-----------••----------- - - - --------------------------- Address------------------Zatrjj'_---_----•-------=--------------------------------------------------------------• ....................-..-•-•------------------------••-•------------------------- Contractor's Name-------------]SAY..-&--- !i-CITE T---,S_._T-.,SSC---------------------------------------------------------•- Phone---RQ---27046--------- Installation will serve: Residence K] Apartment House [❑ Commercial [❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ---1__ Number of bedrooms ---I_ Number of baths -1---- Lot size ---- o-t---x---140 r---------------------------- Water Supply: Public system ZI Community system ❑ Private ❑ ,Depth to Wafter Table Q--- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe XX Hardpan ❑ Previous Application Made: Yes ❑ No = New Construction: Yes ❑ No XX Replacing outhouse in, favor TYPE OF INSTALLATION AND SPECIFICATIONS: of modern plumbing. (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well--N-01ae.---Distance from foyndation---_�Q1-------Material------CC---Brick .r f No. of compartments........2._ SizeJ( ttx36ttx }�tt Liquid depth--.---5911------------Capacity.-9Q.Q---GRIB . Disposal Field: Distance from nearest well-.-..NS)ne-Distance from foundation--19_---------Distance to nearest lot . �, � K} Number of lines-----------1----- _ ---------------Length of each line---- -2-0t_----_- -------Width of trench.-_ 2.T -- f Type of filter material----S.e.T).-Rk-.Depth of filter material---18"1--.........Total length------- _--_-..---- Seepage Pit: Distance to nearest well-ITDne----------Distance from foundation-_ Q_-----------Distance to nearest lot line----- ----- Number of pits-------I------------Lining material--B 7-ick------Size: Diameter----..3 ....--._--.Dept h------20.--------------------- Cesspool: Distance from nearest well---_--_---.-----Distance from foundation------------------- Lining material_'----..----.----.._.----_------.-. — �❑ - Size: Diameter _s=-------_--...-__- _-Depth ;.---: :_ Litiuid.CapacitYf ..... :, als. Diameter------a-- - Privy: Distance from rearest well------------------ ------------------------------Distance from nearest building-.---.----.--.---------------------------. ❑ Distance to nearest lot lire------------------------------ ----------------------------........ ---------------------------------------------------------- .0 ----•--------------------------------- Remodeling and/or repairing (describe):------------------------------`ko --- ---------------------- Z-------------- ----------------- ------ I------------------------=•-------------------------------------------------------- ---------------------------------•-----------------------•------••----------------------------------------------------------------------------------------------- d � ------------------------------------------------ i 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. DAY&NIGHT _ {Signed}----- --------------Septic-Tstnk.5mvice--------------- -- ` -- (�e � r Contractor) ------------------------- ------------------------- 1206 So. Eldorado HO 2.7046 By=--. Stntktorr;C ----------- r {Title} 'ar tier (Plot plan, showing size of lot, location of system in rel t on tom ells, 6u*91,ngs, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY �--------- - ------------__---------------------------------- --------------------------- DATE-V--.-------------------------------------------------- REVIEWEDBY----------------------------- --•--- ----------------------------------------------------------- ------------- DATE----..�•--------------•------------------------------------ BUILDINGPERMIT ISSUED--------------------------------------------------- ----------•--------------------------------------- DATE------- ------------------------------------ Alterations and/or recommendations----- ------------------------------------------------------------------•----•--•---•---...-------•--------�-------------. ------- ---------------.-. •-•---•-------------------------------------------•----------•----------------------------- ------ ------------------------------------•--------•----------------------------------------•-•-----•---•----•-----...T.------ ---------------------------------------- - ------------------------------- ----- F FINAL INSPECTION BY------------- ------ ----------- --------------------- Date----------- �------ -------------------- SAN --------------4 ----------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street $14 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California . ES---S-2M 145446 ATW60D 13-54 ti�