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APPLICATION FO,., .iANITATION PERMIT Permit Na. .. G 5. __7... k 774 (Complete in Duplicate) w Date Issued .�/� � App ica{ion 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. i JOB ADDRESS AND LOCATION. ------i ou a 30x .216-� _� Manteca Owner's Name-----Trank--and Alma Reed -- ---------------•----•------------------- - -------------------------------------------- Phone---1=a---5'-"-5421-....^ ' Address__---2nd_-house_--pa8et--Austin Road on Sq, side Of SouthAv r8. Reed wk, ------------------------------------- x---Mantes --- -- - --- -- - --------- Contractor's Name------ ?O)3_4--.-5-ep.13C__.T. 1k..SBY'T -r'� - -- - �-a_..�T1Gs--------------• -------•------------------•--- Phoria---•1iQ----_j7.72_7----- I Installation will serve: Residence � Apartment House El ❑ Trailer Court ❑' Motel ❑ Other ❑ Number of living units: _1.... Number of bedrooms ----9- Number of baths ..1..- Lot size ----Z-_ acre---- -- ----------------•-----•-----•-- Water Supply: Public system ❑ Community system-❑ Private Depth to Water Table _20- ft. Character of soil to a depth of 3 feet: Sand ❑ pravel [I Sandy Loam ® Clay Loam [] Clay ❑ Adobe❑ Hardpan E _ ` Previous Application Made: Yes ❑: No fl 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------- Q....-Dista�e from foundation---xQ Mater I ..._Ca__.CQ - n J 1 t ----•- - ® No. of compartments 2 ---size------•-�--------------------Liquid depth_... --------Capacify..BQQ------------ Disposal Field: Distance from nearest well ._.Distance from foundation----Wt--------Distance to nearest lot Iine._...5= ® Number of lines---------1-°---------------------Length of each line--------SQ-------------...Width of french------ t----------- ------•- Type of filter material ----------- of filter material-------a -.--_-----Total length-------SQ •-•---------------------- .,_ i t Seepage Pit: Distance to nearest well____U0 -------Distance from foundation.._.94PP..�a_.Distance to nearest lot line...__ ,....- .P ® Number of pifs--------Z__---------Lining materialXQCk----------Size: Diameter._.3Q..............Depth-..- -5 .__ ------•---------- Cesspool: Distance from nearest well-----------------Distance from foundafion---------------- Lining material----- ------------ ❑ Size: Diameter------------------------------------ Depth----------------------------------- ------Liquid Capacity------------- ----------gals. Privy: Distance from nearest well-------------------------------------------......Distance from nearest building ❑ Distance to nearest lot line---------------------------------------------------- ----------=--••---- ----•------- �. f Remodeling and/or repairing (describe):-___IOX----ayat4m--PQZ'.. «» C PQgi _ hpi 8p ---------------------••--••----------•-------- ----------------------------. ---------------- - " � ---------------•---------•-----------------------------•-------------------------------------- ---------- ••--------------•--------- ------- -------•---------------•------•-----------------------------•---- 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. (Signed).............DB).ta__ epie.-Tankervc-e,-..hc, (Owner and/or Contractor) ----------------------------------------------------------- r By: P_exy W_t _. ----- (T;tle}-- -� — .� . ----------- --- -=--- (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY --!------- DATE- REVIEWED BY- = - - --- - ----- -- ---- ------------------------- ------------------ DATE--- 110--------------------------------------------------- BUILDING PERMIT ISSUED------------- - -------------•-----------------------------...---------••-•------------------------._ DATE--'------- -•---------------------------------•------ Alterations and/or recommendations:...-.--..___. ...... "_-__•------_--_ ------------ --------------------------• ------------------------ ----------- --- -,.. ----------• ----------- FINAL INSPECTION BY:------: --- -- ---•--------------- ----- ------ Date- ', SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South Arnericen Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca,California �.... Tracy, California E$-9 145946-WOOD R