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<br /> ,7l Ej 1 FOR,OFFICE USE; �
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<br /> JF 'b"T'u'� •aS i^�" ( y' +..+...;,. • L 1.. � dK yw 1 �� !f�ry Tt
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<br /> -vIRPt.ICATiDtV.FO_R i ERI�tRY �`' �"�v�=?F ,
<br /> _ SANITATION P ryPennrt o::...:_.__1w? '
<br /> (Cornpk�te m DupGeate)
<br /> OV`'v'Ci. 'S!'7^t;•��.-a. Tar.-�:•�rY.f �.` aY...;]t - ..�:r`t-
<br /> *� Permit Ez rris'� Year From Dati Issued ` ti rF�Defie Issued !?
<br /> r�� Application is hereby=meds.to�t�re Sen Joaquin Local 1-faalth.Dist,ct fora permit io construct ar d,� ! ini+all the war he►e, desc kationa This appl t me de 1n compilenee w,th County Ordinance Na 549:
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<br /> IDDRESS N`
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<br /> G4Vfler f l+lOme - •r 1.:+ s. -., {. F_._..- '` �PllOne�4.�j C•./x .Y� •. {
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<br /> ,CoNamer
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<br /> ntractors w ;Phan 7 /
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<br />` r °' , Iritagation willtisi vii d}Resldenca ❑ Apartment House ❑ Commercial © Trader Caurt ❑ Motelt© O}her
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<br /> Number at.EIv1rg amts Huinbor of bedrooms Number cf 66ths Lot sae A.
<br /> fWaFer�SupIP Illbhc;sy`stem:.❑ ` Community:syerem Q Prrve te` :Depth to Water
<br /> '•G'-dt ;ate Ltn-"H�k;.. 3'a.1'.: 1- _ - _ r {, r� u,T„f�1:'S'.',� .�•�J,;Y 't. `
<br /> Cllarader of soil to a'depth of 3 feet _;,Sand❑ Gravel❑ :Sandy Loam[ :.Glay Login Q Cley[] Adobe f${ Herdpen�i:• � '
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<br /> F s -y Prev�rousAppastiom Made I pf yes date 1,No New Construction Yes ❑ No'Q "FHA/VA.Yes❑ 'No;[J "'14
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<br /> TYPE OF INSTALLATION AND SPECIFICATIONS S
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<br /> <-n {r, (No septic tank or cesspool paimri+ad if jaubllc`sewer rs arailabie wl+hrn 200
<br /> } #- •. tar - 5 -
<br /> # a Septic;Yank Distance from nearest well '
<br /> r Dlstnnce from foundetlon Meterlal
<br /> ❑: �� �rz` " No of compartments Slze......_. L1 wd de th F itb
<br /> q P Capacity + o r
<br /> A Dls anal Field ' Di4tance.from nearest well.: Distance from faunae+ion Distance ta'neerest lot line..._
<br /> I .r ` �' ❑-.` . �. - Nurn i:of lines....... ._ ..:Length ofeach'line.:'......- ... Width.of;trench _ �.n� .'
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<br /> i K . .� Sf
<br /> Type of fluter material �....Depth of filter material:_. Total length
<br /> Y„ .: +�
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<br /> Sea a e Pit Distance to.nearest well3Q
<br /> ! p g Distance oundation Dlstan Je to neerest lone
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<br /> Fil Numner of pets .: ._.Lining ma+erral..- ....Size:'Diamefer .. � Depth
<br /> Cess ooI Dlstence from nearest well :. .........Distance from foundation Lining meterinl ..
<br /> Gze Diameter.:-. .. Depth.... Liquid Capncrty Isi �' r
<br /> Privy T :Dlstenc9 {noir+ r+ea•est well.-
<br /> ...................' .....:.'...... ......_'.Dis`ance from nearest bwiding: r t a � s
<br /> F ❑' Distance to nearest lot line.:................................. , � s
<br /> FerncwLng and/or repelring idescnue): (��CLL� C...,. a1.yt•�c ly'Pyr•, } ,�y
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<br /> FillT i _ .....- ............................ ........_........ ............. ...
<br /> r ! { .• ........................................ _.............- ........ ..... .......................... t.' .�"Tr•r'y'�
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<br /> a I herebycert;{ "that I here re ared this application and that the work will be done in accordance with San Joequin County
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<br /> q „ordinances State la and rules a regulations of the San Joaquin Local Health District
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<br /> ._.... ._...... d/oro,,
<br /> ey:....:.......:......................: �.... ......._.. ... ......(Title) t ` '
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<br /> �ner en ontras
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<br /> (PIot.plan, showing size of(ot, location of sys+ in relation to wells, buildings, a tr., can be placed an reverse side].`
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<br /> FOR DEPARTMENT USE ONLY urk h f
<br /> . APPLICATION ACCEPTED BY_ ............... . ......................:................................ DATE...._..
<br /> REVIEWED BY...:. ...... .. DATE ..... u ~�
<br /> i3UILDING PERMIT ISSL3ED....::....'................................... ............_... .................... DATE.:.......:............................ w
<br /> teaF _
<br /> Alterations and/or recommendstions:................ ... ...... .. . ... . ......................................................
<br /> ........... .....................................
<br /> ...»........................... ........ .. ... - .......... .......-...-..-....I.............................
<br /> ....r......... .................. .... ... .. .....-... .....................................-.-....... .... ..........,........ �rks
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<br /> FINAL INSPtCTl�7—fiY: I /�L�. �,' TLS Defe... ...........!,T... _... ../>...................... t
<br /> SAN JOAQUIN LOCAL HEALTH DISTRICT
<br /> "- 1601 E.Haullen Ave.
<br /> 300 West Oak 5tnet 144
<br /> {^ _ Sycamore Street 205 Wert 9rh r r, mss?
<br /> Street -
<br /> [ - 119dien,Cai7fernia Ladi Ceiifornia Manleca,California
<br /> Tracy,California
<br /> E.H.S 2M 1,07 Yon Fwd
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