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off- .t t APPLIC TION FOR SANITATION PERMIT Permit No. __7-.'_.._ .. \�4�� ` ;U U �. M • (Complete in Duplicate) z, Date Issued 7._/6 ____..._. Application is hereby made to the San Joaquin Lo a�1 t-1r3aith District for a permit to construct and install the work hereiAW scribed. This application is made in compliance with County Ordina No 549. QQ Cal expo e"hi r JOB ADDRESS AND LOCATION........ _.._ . 19-----t2.�-._._��_o&_ fef�--Jv..9A(q Owner's Name------------------------ ---------- -j Q t T3 -------------------- -------------- Phone .. --- Address.................................................stow--me -- Contractor's Name-------- ` A �'�E Phvne.. Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Ot Number of living units: __ __ Number of bedrooms Number of baths J:__- Lot size ___�.lf_Q.~_ ._. -------------- Water -- _--___--_ Water Supply: Public system ❑ Community system ❑ Private 0- Depth to Water Table W9 ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay❑ Adobe, Hardpan ❑ Previous Application Made: Yes ❑ Nopl(j_.New Construction: Yesjd—No ❑ " TYPE OF INSTALLATION AND SPECIFICATIONS: NZY (No septic tank or cesspool permitted if pu lic sewer is available within 200 feet) Septic Tank: Distance from nearest well ----Q-- ---Distance Flom foundation... f---_.Material- No. of compartments____ _ _Size__b`2_Z_F.�t67.0 ..__Liquid depth ,; --1! __ _` _---.Capacity df Disposal Field: Distance from nearest Distance from foundation 0 - Distance to nearest lot line./!P_'_. Number of lines_____.�...__t _�y__ _-----Length of each line.... _�_°____-Width of trench__ . ' '`' Type of filter material• -�-- ____ ____Depth of filter material-_-__Lr.-__Total length_-, D_� __._ Seepage Pit: Distance to nearest el ___ ___ _______Distance from foundation ...Distance to nearest lomat In^�.. u �� Number of its_ Linin material _=Size. Diameter____��:____._.De Depth __ /w'� p g . -- . 1 P 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 -------- -------- •,----- --------- Remodeling and/or repairing (describe):-------------------------------- -- -- ---------------------------------------•------ ---_----- ........................................... ---------------------------------------------------------------------•--------•--------------------_-_-------------------------------------------------------------------•--------------------•------------------------------- ------------------------ -------------------------------------------------------------------------- -------•----•-•••------•-•----------------------------------------- ------------------------------------ -- I hereby certify that 1 ared this application and that the work will be done in accordance with San Joaquin County ordinances, St la , n ules a regulations of the San Jo a al Health District. "`` la-_t-_--__S_____-1- -- -- t1_ _S -- . _ _G-! r Contractor (Signed)-----�-- 2 2 By------------ ---- ---- --------------------------------------------(Title)- S. .V�-, ---- ---dl.. ............. (Plot plan, showi' 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__________ __________ Vl _ DATE - 7 ..____ '` REVIEWED BY... --- --- -- ---- --- -------- -- •. DATE- ------1---------