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_1 d APPLICATiON FOR SANITATION PERMIT Permit No. __----_-_-------------- Ile (Complete in Duplicate) Date Issued yl Apphca�ion is hereby made +o the San Joaquin Local �th Dsstnct for a permit to construct and install the work herein described. This application is made in compliancewit nty�Ordinance No. 549. JOB ADDRESS AND LOCATION 1' '------ )144__. r--------� tc f��4 --------------------- f ------- Owner's Name------ ----------------- r'-------�►<---- _. �_4 l"'f1Y�----------- -------------------------------------------- Phone.TTU----VJ_27_[ Address-----__1Q..63_6-- I"lur_ke f- `` �'{ `�---- s_.►s�A �� G p � �../� r s Name-------------- -------- c " ""7----- Phone_�T�/. J` nt Howe Commercial Trailer Court ❑ Motel ❑ Other ❑ Installation will serve: Residen a �Apartme ❑ ❑ Number of living units: _J_ mber of bedrooms __2` Number of baths 4.--- Lot size ____ __/-__._- -_ -------------- Water Supply: Public system Community system ❑ Private ❑ Depth to Water Table -------- ft. Character of soil to a depth of 3 fee+: Sand Gravel F1Sandy Loam [:] Clayy�Loam ElClay ❑ Adobe [j� Hardpan ❑ Previous Application Made: Yes ❑ No ew Construction: Yes ❑ No ❑ o7!/wf7�PthN/3� �"/ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) S isa 4 Distance from nearest well.................Distance from foundation-------------------- l- __-___.Materia ___._______.___________..__________..______----. No, of compartments-------------- Size--------------------------------Liquid depth------r---------------- --- --- -------- Distance -------- s l *J: Distance from nearest well.. Distance from faundation.__f /_......Distance to nearest lot line____4.__f._. Number of lines------- ---------Length of each line__7.0--'0-----.------.Width of trench.+�_- ----------_-..___________ Type ort filter 'material_.- -----7----Depth of filter material--- Total length______ -----___________________ Seepa e Pit: Distance to nearest well ___________________Distance from foundation-------------------Distance to nearest lot iine.-_____-___.____. Number of pits---------------------Lining material--------------------- Size: Diameter--------------.--------Depth--- _------------- N Cesspool: 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---------------------------- ---------------------•------------------- ----------------------------------------------•-------------------- Remodeling and/or repairing (describe):--'______________________ --•--------- ------------------------•------------------------------_- -------------------•--•------------------•-•------------ -------------------------------------------------------------•--.---------------------------------------------- --------------------------------------------------------- --- ---—..- certify that I have prepared this application and that the work will be done in accordance with San Joaquin County I hereby c y P p pP ordinances. St ws, and rulekevriqegulations of `thJeie San Joale ealth District. (Signed)---------- X ,J �-------- �.�� - --f C�� •------ ----(Owner and/or Contractor) By: ► '`^J- & - ------------ - [Title) ;+ `) --- ---------------- - (Plot plan, showing size o ot, loca+ion of sys em in relation to wngs, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-F __._-_ DATE-- ---------•--------------------------------------- REViEWED BY -------- Y- DATEQ^ BUILDING PERMIT ISSUED---------------------------------------------------------------------------------------- ------------- DATE--------- - Alterationsand/or recommendations---------------------- ------------------------ ----------------------------------------• -------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- -------•---•----------------------•--------- ---------------------- ----- --------------------- ---------------- ------------------------------------------•-------------•--•---------------- --------------------------------------------- ------ ------------ W ~ Date_... -------------- --------------------- FINAL INSPECTION BY------------ --------------------- -- '� `' -- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California E5-9^-ZM 145446 ATWOOD 12.54