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! APPLICATION FOR SANITATION PERMIT Permit No. � .. - ° (Complete in Duplicate)This Permit Expires 1 Year From Date Issued Date Issued __{_/ .__ _ __ Application 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----------1829---Ea,st___ 2th-_Streets------Stockton, Calif, Owner's Name---------Jack D Maple ---------- ----------------------------------------------------------- Address--G_3$___S-0Ut1a_RQaa�e--- treet. AnaheiM Calif--------------------------------------------------------------------------------- Contractor's Name-------Delta.-__Septi.a.._ Slk__Sex'Vi-CgInc.---------------------------------------------•--- Phone-Ho•__.3-----1269 Installation will serve: Residence J] Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other E] Number of living units: __. - Number of bedrooms --2___ Number of baths ----I_ Lot size ---fr15X9.0-----____________________________________ Water Supply: Public system E]: Community system ❑ Private ❑ Depth to Water Table __40 ft. Character of soil to a depth of 3 fee+: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ® Hardpan ❑ Previous Application Made: Yes ❑ No [?q New Construction: Yes :F] No ❑ FHA/VA: Yes ❑ No 50 TYPE OF INSTALLATION AND SPECIFICATIONS: ° (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Se f' Tank: Distance from nearest well-----------------Distance from foundation___________________Material-_-___________---__--_____________--__-_____. EgSting No. of compartments--------------------------Size-------------------------------Liquid depth---------------- -------.-Capacity----------------------- Disposal Field: Distance from nearest well-----------------Distance from foundation--------------------Distance to nearest lot line_________--_...-- EM1sting Number of lines-----------------------------------Length of each line------------------------------Width of trench__.----------.--------------------- ^-�► Type of filter material-------------------------Depth of filter material-----------------------Total length----___________.---.____________-_--_____ Seepage Pit: Distance to nearest well-------None---Distance from foundation__AZ,P1_e__.DistagFe to nearest lotjine____5-t ® Number of pits-------.T-----------Lining material__RGCk-------.Size. Diameter--------31----.-----Depth---95__--MaX...----__ Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material___---_..__-____._-------__-___._ ❑ Size: Diameter----------------------------- --------------------------------Liquid Capacity-------------------- g Depth ala. Privy: Distance from nearest well-------------------------------------------------Distance from nearest building------------------------------------------ F1Distance to nearest lot line---------------------- ----------- --------------•----------------------------------------------- ---------------------- -------------------- Adding Seepage pit to existing system. Remodelingand/or repairing (describe):---------- - - - -------------------- --•-••-----------•------------------------------------------------------._..--------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------- - ------------------ -------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------- - 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)-------Pelta---8eptic----Tank--se _1-0-P--" ------- - ------- ------------------------------ --------------------(Owner and/or Contractor) Peary 0 Warthan / (Title) Gen. Mg By:--------- ----- -- -- --- - ----- -----------------------( )--------Gen- --- - ---------- .. ---- --------- (Plot plan, showing size of lot, location of tem i rela+ion to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY I APPLICATION ACCEPTED BY---------------------------- ( DATE i.�- 1 REVIEWED BY--------------------------------------------- DATE BUILDINGPERMIT ISSUED-------------------------------------------------------------- ------------------------------------- DA-TE____.-------------------------------------------------------- Alterationsand/or recommendations:--------------------- -----------•---------•--------------------------------+---------------------------------------------------------------------------------- _ ------------ ------------ - ------- - - --------- ---- f f D_ ----- 76?_(