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FOR OFFICE USE: ----- _ : /-.._-. .. APPLICATION FOR SANITATION PERMIT Permit No. '- Cam lefe-in Duplicate) /r PDate Issued ---------------- .._4 a Y, - is Permit Ex fres 1 Year From Date Issued Appli a ioni ereby made to the San Joaquin focal Health District for a permit to construct and install the work herei described. This application is made in compliance with County Ordinance N 549. �J�� AJ, JOB ADDRESS AND LOCATI }.:/.41,Z SA-------+f°-�-. .-°�---------- N----� PP.�i2b�z�l+,S---- --�� - { Owner's Name. IiI AA ------------ Phone- 3. ------- Address--------------------- Contractor's Name-------------S-T4-,"-!-46------------- ----------------------------------- -- ---- -- ----- ------ ---- -------------------- Phone----------------------------------- Installation will serve: Residence X Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other . I Number of living units: __ - _ Number of bedrooms _S._ Number of baths -------- Lot size ----- - dv --- ----------------------- s, Water Supply: Public system ❑ Community system ❑ Private Depth to Water Table ______ _ ft Character of soil to a depth of 3 feet- Sand d. GraTel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ AdobeX Hardpan ❑ Previous Application Made: (If yes,date-------------- J° No ❑ New Construction: YesNo ❑ FHA/VA: Yes ❑ No C.� TYPE OF INSTALLATION AND SPECIFICATIONS.':' (No septic tank or cesspool permitted if public sewer is available within 200 feet.) / i✓Cade%e . Septic Tank: Distance;from nearest well r ----_Disfanc Mfr foundation_______ __ _______Mate i I _ _ ------------_-__ I---- 9 I _. Li uid de th__ ' . ..�_. Ca acitNo. of compartment __.__.._.__-._ _.______Size___ ____ _. _ __ _ q p P Y-�bis os I Field: Distance from nearest well.._...3�_Distance from foundQa�tion.- __1�__ J]istance to nearest lot linyeNumber 6f�iines-___ ..._.._.___ f __ ength of each ine . (][-5,4 Width of trench----- - 4!n__ Type of filet. materia`• �. -.. .___ pth of filter material ___total length_._ o n rest well....J� r-----Distance from f undation----/Q '__..Distance to nearest lot line________ Seepage Nlumberr f�..._Ip_Z------_Lining material--- .._. Size: Bret++e+er__ .-_..----Depth----410'�'_j-------- --- --- Cesspool: Distance from nearest well ___----- ......Distance from foundation...._....__.._.. . Lining material_________________ ________ D L Size: Diarrleter_ --1 _ ._t----- ----------------Depth _ _-- . -_ -- (- _ ._Li uid Ca acit ❑ � � - -c . � p - - - - - - - G p Y----------------- gals. , Distance from nearest building Priv Distance rom nears; t well. F....................................._. ._- Y , g - .� ❑ Distance to Weare t•lot line - ------------------------- r � Remodeling and/or repairing (descrbd; ---.-- _ ______ _________i._____ _____ ---- -------: - I.r✓ ------------------------------------�� ----------- ---- ------------ 16 - �. C�E --------- - '------- --------------- �,/ ---------------------=- ------------ ----- -------`------ - - -----------•--- -- --- ' -----------------------------------------------•----- I hereby certify that I hav _prepay d.-thi!;-4; ?litatipp-and-J.ha thelwork wit, e do to accordance with San Joaquin Counfyr ordinances, State laws, and rull s and. regulations of the San Jca. n"L`ocal Health District. (Signed).__- ��- 1r - ---- --- ------------------(Owner and/or C ntr,,ctor) E r sy:... 1 - ----- ------------- - (Title) -------------- 1 ..... (Plot plan, showing size of.lot,location.of t n�zlafion to w.ellst.buildings, etc., can 'be placed on reverse side). P FOR DEkARTMENT USE ONLY 4 APPLICATION ACCEPTED BY----�-- -- ---�.C�O - ----Gt��--�--------------------------- - ----------� DATE-------- -- - �- - ---��--� - -�' -------- ` t REVIEWEDBY------------------------------------ -- --------- --- =----------------------------------------------- ------------- DATE-- ----------------------------------------------------- j BUILDING PERMIT ISSUED-------- --------- -- ------------------ IDATE_-- _-- -- I � - i �^ 7 --------------- of d ----- --------------- . Alterations and/or recommendations:..- -. . +.;.+ � � .___-- - --_ ___._.__ _ +n -------------- -------- -------- ------------- -- -.---- ,_ =t --------------------------------- . jf- FINAL INSPECTION ( BY:---- ----._. Date---- -- SAN 4 JOAQUIN LOCAL HEALTH DISTRICT f 7 1601 E.Marelton Ave, 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California f Lodi. California Manteca,California Tracy,California E.H.9 2M 1.67 Vanguard Press e