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i � 3 APPLICATION FOR SANITATION PERMIT Permit No. 2-rr--_4 /--_-_ pn ' (Complete in Duplicate) � Date Issued ___�Y��-�� tifj �I� Applica ion is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This a0plication is made in compliance with County Ordinance No. 549. 142 Sierra bane Stockton JOBADDRESS AND LOCATION----------------------------------- ---------------'---------------------------........---------- ------------------------------------------------ ------------- Mrs, Arnold Reiske 3-5448 Owner's Name------------------- - --------------------------------------------------••----------------------- ---- Phone II 14.13 Newport S-. Stockton Address------------------------------- ---------------------------------------------------------------------------------------------------------..... 11 PARA ISH IN C . 446-07f ContractorsName--------------------------------------------------------------------------------------------------------------------------------------------- Phone----------------------------------- Installahtion will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court 0 Motel ❑ Other &j Duplexes " Number of living units: A---- Number of bedrooms _-_8-. Number of baths .------ Lot size _ x__ 2a t Water Supply: Public system & Community system [:1 Private ❑ Depth to Water Table 4o... ft. plus Charai�ter of soil to a depth of 3 feet: Sand E] Gravel E] Sandy Loam E] Clay Loam 0 Clay [] Adobe [4 Hardpan ❑ Previous Application Made: Yes ❑ Noit New Construction,. Yes N No ❑ I TYPE 8F INSTALLATION AND SPECIFICATIONS: I (No septic tank or cesspool permitted if pu 'c sewer is available within 200 feet.) Septic Tank- Distance from nearest well-_Ns.�e Dista Mfg ff �undation--_�- ?_-------�r}t�riai-CC Brick No. of compartments---3 __MlE lUU 1� Liquid de th__.__ _L. ................Capacity - 'r Ix -a �� N--- q p. p y----------------------- Disposal Field: Distance from nearest2well___N r_ ._Distance from found q___15 _*..Distance to nearest lot lige__-_ Number of lines---------------- -tt Length of each line...-._ '---. --35-1 Width of tren fi- 24 ----------------- 71 � Type of filter material_._.___._ _ Depth of filter material-----------------------Total length-._______-------..------__.---.--_--__-- See a� a Pit: Distance to nearest well_-ITO a Distance from foundation____ ; I 4 5 P g 1 r C C BrJ ----•-_._4D ante to nearest 'ne---- ----------- ® Number of pits --- -----Lining material-------------- -------�ii e. Diameter_ - - -- - .--.----Deptn---------------------------------- ! Cesspi ol: Distance from nearest well-----------------Distance from foundation--------------------Lining material____.__-____._-._------.--__----. ❑ Size: Diameter--------------------------------------Depth---------------------------------------------------.Liquid Capacity----------------------------gals. Privy: Distance from nearest well-------------------------------------------------Distance from nearest building----------------------------------------_ ❑ Distance to nearest lot line--------------------------------------------------------------------------- -------------------------- -------------------------------------- Remodein l ` 1e airin d 2 Arbor Villa units of 2 units each. . . 11 VaapgAe- )k65: -_-•---------------------------------- - ------------•---------------•----•-•---I•---•.--------------------------------------------------------------------------------------------- -------------- - =- ------------------------------------------•------ -•--------------- --------------------------------------------------------------- I I hereby certify that l have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and �'guia 'ons of the San:Joaquin Loc Health District. I c �_ F (Signed)-------------------------------------- Ia H - C------ ------ --- - - --------------------{�Contractor) 113y: ------- --- - -- -- - - - Estim2for - -- ---- ------------ ---------G'------ ------- -- (Title) (Plot plan, showing size of I locatio system in relation to wells, buildin�tc., can be placed on reverse side). lf� FOR DEPARTMENT USE16NLY APPLICATION ACCEPTED BY ----- - --------- QATE------------- '. REVIEWED BY--------------------- �` "� s ---------------- DATE------------------------------- - BUILDIhG PERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE-------------------------=----------------------------------- / Alterations and/or recommendations:_. C1 -------.r_. ..,_----- --F- -- ._ -_-•--- -' ° ----------_---------- --------------------- ---------_---------- ----------- -------- - ----- --- , -- ----------------------- ---- -------- ----- -----------------------------------------f--------------------------------------------------- ------------il -- ----- ------------1------- ---------------- -- -- -------- ------- ---------------------------------- -------------------------------- --------------------------------- -------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------- I FINAINSPECTION BY:---------- r -`............... Date--------/. /_ � I ----------------------------------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT s 130 South American Street 300 Wast Oak Street 132 Sycamore Street 814 North "C" Street IM Stockton, California Lodi, California Manteca, California Tracy, California y, Y ' a0-52 Revised W-2100