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APPLICATION FOR SANITATION PERMIT Permit No. ._S.5-,3�, (Complefe in Duplicate) + Date Issued ---91710_ 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---------------2115 East 6th. Street, Stockton. Cad Owner's Name---------- - --------------- O.J. Johnson -----••---------------------------•---- ---•-- --------------------------------------- ----------------------------------------------------------------- Phone.---------�-------- Address-------------------•--------"-".='-------=--------------�31oe. - r -•------------------------------•--------------------------- - T y . -------------- Contractor s Name---- �----•------•----------'---�a�`S'�.,SYl�---.Lf}.C_..----•- --- ------ Phone:I-0_-6-9667------- - - ------------------------------------------ -- Installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other M Trailer Number of living units: _- 'Number of bedrooms _-____ Number of baths Pg__ Lot size _ 12- _60x5 House ------------•=----- Wafer Supply: Public'system ® Community system E] Private ❑ Depth to Water Table � _�__ ft. Character of soil to a depth of 3 feet: - Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe® Hardpan ❑ Previous Applicafion Made: Yes ❑ No;R New Construction: Yes ❑ No TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well---11QT Q__Distance from foundation__._..-5 __C�nCY'et2 --�--- [ No. of compartments 2 Size b 3(a--------Liquid depth=-5O_"1----------------Capacity--- ---- .a Disposal Field: Distance from nearest well..............._Distance from foundationz:N--_.____--____.Distance to nearest lot line___..___.-_______ ❑ Number of lines--------- ------Length of each line------------)-----------------Width of trench---------------_----- ---- --------- � Tyke of filter material-------------------------Depth of filter material-------------------------Total length____-____-___------------------------------ I Seepage Pit: Distance to nearest well-.190,le___---'_Distance from foundation_ ; - � _____________Dis=ante to nearest lot line�n�_------_ i � Number of pits-__011e.---____---Lining material__-_Bri-ck__-Size: Diameter_._ -___-___- esspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material-_.__-_.---___._ 1n ❑ Size: Diameter--- Depth_ ----------- -=------ ---------- - --------Liquid Capacity----------------------------gals. Privy: Distance to nears + crest well____ _________.-_Distance from nearest buildin y: Distance from ne g------------------------------------------ El �) , st lot line______________ - - • ----------------- Remodeling and/or repairing (describe):--------This--_S.ys_�em._1aill___S_exv _Qlle___L'i43 �--j�fflQ---��pes ]zn a 6 ` -------tr-ailer---hoes;---an---the-- prapext_v.-------------------------- ---------------------------•------ ------ -------------------------- -- -------------------•-r------------------------------------------•------------- ----------- I hereby certify that I have prepared this Applicafion 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. (Signed)---------------aa_Zr_jSjj.9 i1C. ' / ------ -- O By------------------- Ia acs �- Parrjsh r Contract - - - - wrier and/or or} - --- - - - -(Title)---___.President (Plof plan, showing size of lot, Iona+loo of system in a+ion. to wells, buil rigs, etc., can be placed on reverse side). t FOR DEPARTMENT USE ONLY i APPLICATION ACCEPTED BY----------- -------------------- --- „_ -- ---------------------------------------------- DATE----- REVIEWED BY ----- ---- ", �: ---------------------------- ----.- DATE flW .. BUILDING PERMIT ISSUED---•---------------------------- - --------------•------- ------------ ----------------------------- ------------ -------- DATE_ Alterations and/or recommendations:______- _- --- ------ ----- rc. -- �/ ------------------ - ------ - -----fn_ ._/ ---------------=�� =�" °�/� - ------.- -- . R- - ------- - ---=-------------------------------- 4 ----- ---- - ell .-- < � - l�t/�l -�--e_--. n e ---S r ---- -A-f-4 t ---------- �� s _ -E__. -. / - ._ ter-- -----------rG �t--------------- --------------------------- ----------------------------------------------------- FINAL INSPECTION BY;--------------. J . -A ------------- Date------- �f SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" street Sfockton, California Lodi, California Manteca, California Tracy, California j ES-4-2M ; Revised W-2100