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---- ------------------------ Permit No. ..02..��- ------------------:------- A�_ 'KATION FOR SANITATION PERM (Complete in Duplicate) Date Issued �7=.XZ--*--,7 ----------------------- -- --- ------------ This Permit Expires 1 Year From Date Issue pp A lication is hereby made to the San Joaquin Local Health District for a permit to cons rust an install the work herein described. This application is made in compliance with/County Ordinance No. 549. h A / .� t�0-e.�.v✓ --I---rX---------- -- -------r...-__.............--•-•---- JOB ADDRESS A --------- LOCATION________________________•-------• . ---------_ 4�L ------- ------ Phone. = Owners Name .......... Is Address---- 7 ---- ------ --------- t one -- -- - --- - --- ------ ---- e22*e_FW Name..... Motel ❑ Other�� Installation will serve; Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court ❑ Number.of living units: _r . Number of bedrooms'- Number baths __:.... Lot size _1_42;19-444- -- Water Supply: Public system ElCommunity system [IPrivate Depth to Water Table _ _-. ft. Clay Loam [Clay ❑ Adobe❑ Hardpan ❑ Character of soil to a depth of 3 feet: Sand [] Gravel ❑ Sandy Loam❑ Y FHA/VA. Yes ❑ No [3Previous Application Made: if yes,date---------------------I No ❑ New Construction: Yes E] No C3 TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.)' Distance from nearest well-...r1 i7___�.._Distance from i foundation__.1..7....-----i�later�1._. — N Septic �j --- 3 x A.$.!..Li Liquid de th_----- Capacity---f �� tn1 No. of compartments.------------------- .- 9 p• Dispos geld: Distance from nearest well___.Sn_...-..Distance from foundation----L?----------- --- W dthcoftfrenchest�t line--------- •----- OVNumber of lines.__._..._.�-----------------------Length of each line--------- --------------- -------------- - -- ----- Type of filter material------�_:-.1-----Depth of filter material-------/_9 - -----Total length__.. _....--------- ---------•------ � Seepa Pit: Distance to nearest well-----1-dQ.....--Distance from Loundation--J-0----------Distance to nearest lot line..-'5.------- .41 i material.-----5 ---.Size: Diameter-& --- LyNumber of pits.__-....1._.__. ---Lining - -'- Depth._3S. .....Distance from foundation._.-._------------..Lining material-_...-__-----------------__-.-_.a�$ Cesspool: Distance from nearest well............ Size: Diameter------------------------------ ----,,-Depth---------------------------------------------------Liquid Capacity----------------------------9 Privy: Distance from nearest well................_.__- Q ❑ ------------------Distance from nearest building-------_.--------------------------------- Distance to nearest of line---------------------------------------- ------- ----------- Remodeling and/or .repairing (describe)--------------------------------------------------------------------------------•--- ----------------------- �] -----•---•---------------------•---..-----------------------------------------------------------------------------•-------------------------------------------------------------••-•-•------------------------------- O ---------------------------------------------------------------I-------------------------------------------------------.------------------------.---------------------------------------------------------------------------- ------------------------------------------•-----------------------------------------------------------------------••------------------------------------------------------------------------------------------------------- I hereby certify that I have prepared this application and that thwork cal Heawill l be done on stn accordance with San Joaquin County ordinances. State laws, and rules and regulate the San Joaquin r and/or Contractor] (Signed). --- -- ------- -------------•--------------------------••--------------- ------------------ By:----------- -------- ------- ---------------- ---------(Title]--------------------------------------------- ---------- (Plot plan, showing size of lot, Notation of system in relation t weNs, buildings, etc., can be placed on reverse side]. FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY__-- -------•---------------------------- --- DATE...2--!2--n -7---------- ------------ - REVIEWED BY-------------------------------------------------------------------------------------------------- DATE----------•-------------•-------- -------------------------- BUILDING PERMIT ISSUED--------••----------•------- ------------------------------------•------------ ---------••----------- - Alterations and/or recommendations:---------------------- --------------------- ----------- --------------------- ----- ----------------------- --------------------------------------- t + 'BY:...--��___-.---.•--- -- -- -- ----- - --- ------- Date--- ---�--}-�/---------------------------------------------- FINAL INSPECTION I SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Ha:alton Ave. 304 West Oak Street 124 Sycamore Street 205 West 9th Street � Stockton,California Lodi,California Manteca,California Tracy,California t