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Al�U Permit No. r �1eth (CATION FOR SANITATION PERMIT I (Complete in Duplicate) Date Issued --��-- This Permit Ex ires 1 Year From Date Issued Applicafiion is hereby madn Joaquin Local Health District for a permit to construct and •snstall the work herein described. This application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION-------------------Wi-lk_insDa---Man-ex-------Lot---#-47------------------------ G 3O Owner's Name----------------------- e4sdbr i-d e----R-t-&-1 t ---------------------------------------- Address-----------------------------•-----------------19 2 Pa C I f i.c---Aves----------------------------•-------------------------------------- ------------------------------------------•- Contractor's Name------ 1ai0_t_A.__ 4�4 .'�Y Sex-ex---SpTv-tc-e----------------------------------------------- ------ Phone..H4f---5-2-64k------- Installation -2f+ •------- Installation will serve: Residence :K] Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ---I_ Number of bedrooms ._ " Number of baths ---x"_ Lot size ---______-X_____________•------------- Water Supply: Public system ❑ Community system ® Private E] Depth to Water Table -------41)� Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ® Hardpan ❑ Previous Application Made: Yes ❑ No ® New Construwtion: Yes Ej No ❑ FHA/VA: Yes 5] No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well-X;----------Distance from founclatio-A-0--------.MaterCapacity ae riff l�4Q No. of compartments-------2------------ --Size-.-----`�6___X-__4C1-,-__Liquid de th--4 __--.-____-------- P Y--•• - ----------- Dis oral Field: Distance from nearest well----XX----_--Distance from foundation-----IV -_�--Distance to nearest lot line' Number of lines.R--------------------- Length of each linjts ---«��---Width of trench---- � _- ---- \ Type of filter material -----3ZAC k------_-Depth of filter material--I$---- ------_Total length--15-0'__------""_--------t Q 01 Seepage Pit: Distance to nearest well---xx-------------Distance from foundation-----1---------------Distance to nearest lot line_-5__-.--...- W Number of pits------2-------------Lining material--ro—CA----------Size: Diameter....33-"-----------Depth---45-1-------------------- Cesspool: Distance from nearest well-----------------Distance from foundation--_----------------Lining material--..--------------------------------- El Size: ---------.-_---_----------❑ Size: Diameter---------------------------------------DeP th----------------------------------------------------Liquid Capacity----------------------------gals. Privy: Distance from nearest well----------"--------------------------------------Distance from nearest building------------------------------------------ n Distance ----"""---_------------------------------❑ Distance to nearest lot line------ ------------ ---------- - -----------------�--------------•-------------------------------------------------- New septic System ---------------------------------------------------------• ---------------- Remodeling and/or repairing (describe)-------------------------- ---------------------------------------------------------------"-----------------------------------•------------------------------------------------------------------------- ------------ I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin Courify ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. (Signed)--------------------------------ROT0___R-OOT _ 2n� {Owner and/or Contractor OWNER - -- -------- ----- ---------------- (Ti#le}------ - --- -----------------_... (Plot plan, showing size of lot, location of em in elation to wells, buildings, etc., can be placed on reverse side). FOR DEPAR TVAENT USE ONLY --------------------------- APPLICATION ACCEPTED�BY_ .- - ---- --`---------------- ------------------------------ DATE-----------��_—/--REVIEWED BY DATE '---------1-- ------ DATE------------------------------------------------------------- BUILDING PERMIT ISSUED------------------------ and/or recommends ions:-- --- D --- -- "A�----< ----------------- �--�r � � ---T,, a,,,, r .1 ----------------------------- --------------------------- -------------------------------------- ----------------------------- - --- --- : -- � — s--------------------- Date-------- -------------------------------- FINAL INSPECTION BY SAN JOAQUIN LOCAL HEALTH DISTRICT Sycamore Street 814 North "C" Street 130 South American Street 300 West Oak Street 132 S Y Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2M Revised 8-'59 F.P.Ca. k , -