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FOR OFFICE USE: <br /> .................I...... -- .._......_-,.............. <br /> .......................................... ............. APPLICATION FOR SANITATION PERMIT Permit No. .107-.X2. <br /> .......................................... <br /> (Complete-in Duplicate) Date Issued 25;��.oF'-47 <br /> .............. ------- ............. . ......... .... This Permit Expires 1 Year From Date Issued <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct end initall the work hvrein described. <br /> This a plication is made in compliance with County Ordinance No. 549. <br /> 1-7v l 7 AJ- LO utLT 211 <br /> JOB ADDRESS AND OCATON. <br /> AP <br /> Owner's Name. Al!"I- --------------- ... <br /> .......... <br /> ..;� .. . . ........... ............. ......I------ Phone........----'--•-------------- <br /> Address----------7a----- ----- - - -- - ----------- ............. <br /> ................ ------ -------........................ <br /> Contractor's Name.......... <br /> .. .....................................*...❑...... <br /> -- ----------­❑-------------- -- <br /> --------------- ------- Phone............................. <br /> Installation will some: Residence ff,�Apartment House [] Commercial E] Trailer Court C] Motel [] Other El <br /> Number of living units: -/-- Number of bedroomsol.... Number of baths .-?7��Eof size ....................... <br /> 5 <br /> Wafer Supply: Public system 0 Community system [] Private ETIDepth to Water Table ....... ft - <br /> Character of soil to a depth of 3 feet- Sand E] Gravel C] Sandy Loom Clay Loam 0' Clay[I Adobe 0 Hardpan C] <br /> Previous Application Made: (if yes,date................... I No E] New Construction: Yes [-] No C] FHA/VA; Yes F-1 No F-1 <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (N* septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic 104: Distance from nearest well---V&..�..Distance from foundation...., .....Material..__..olrel� ......... <br /> No. of compartments..._.....'. ........sies,4d'..i&,-A-4.'Liquid depth-------y..... .......Capacity.../X424 <br /> Disposal <br /> Id; Distance from nearest well...4.�e... Distance from foundation.....ZY..........Distance to nearest lot line............. <br /> ....... <br /> Number of lines..... Length of each line.- ...........-Width of trench.-A..........--............. I <br /> rial ...... <br /> Type of filter mate ....i....Depth of filter material-----/.,#..........Total length....2 ...................... -1 <br /> Seepage Pit: Distance to nearest well......................Distance from foundation..................Distance to nearest lot line................. 0 <br /> 11 Number of pits... ..................Lining material...................... Size: Diameter....___..__.-..........Depth........-........................ <br /> C05SPOOl; Distance from nearest well ................Distance from foundation..................Lining material..._......._...._.__.__......__.._.._ Z <br /> ❑ <br /> aterial.........----------......--------- <br /> 0 Size: Diameter. .. ..............................Dept h.......................------------..............Liquid Capacity.....................--"--gals. <br /> Privy: Distance from nearest well................__..-.....................__...Distance from nearest building.........___-.......__......._....... <br /> 0 Distance to nearest lot line ........................................................................................................... <br /> Remodeling and/or repairing (describe):......---------------'-- ............................... <br /> ------------------------------------------.........................................................................--.-.................................................................................... <br /> .......... .................................................. ..........I--............---............................... ................................................................ <br /> .......... ............... .......................--. I........................................................................................................................................... . <br /> ll�hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinalfrices, State laws, and rol s and regulations of the San Joaquin Local Health District. <br /> /4 j <br /> (Signed).......... ................. -T---------------- -=IllaId/or Contractor) <br /> By: ..... ------ ... .................. <br /> --..........................;! -.1.....61a,:: ........................---(Title)--............... -----................... . . <br /> (Plot plan, showing if" of lot, location of system <br /> in relation-to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY...... <br /> T-40.. ......................I------- DATE..... .................. <br /> REVIEWED BY....................... .. <br /> . ...........-------------------------- ...........-I........................................... DATE__......---- ..........................-*-------- <br /> BUILDINGPERMIT ISSUED..................----------------............... ............................................ DATE.. .........._.........-----'----'--------- ----- <br /> Alferailons and/or recommendations:----............_.._............................--------................................................................................................. <br /> I <br /> ..............................................................................................I...................................................................................................................... <br /> ....... ------- ......................................................................--------- .......................... .............................................:..................--------...... <br /> ..........:.................. .I....................... .....................................................-. ....................................................................... ....-................ <br /> ............................... .. ..........------- ................................................... ..................I---------- ........ .................................... ............... <br /> FINAL INSPECTION BY:---fe-Z.. Date..... 7- 4,-7' <br /> .. ..............--.1....................................... <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E.Hw.ft.n Aw. 300 West Oak sneer 124 S,,.rra,.Sn.0 205 W*.t 9th Sh"i <br /> Sfo,kl*n,California Lad[ California M.M.<.,C.I;f.,ni. Tracy,California <br /> EA.920011-6] Vanguard Res, <br />