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FOR OFFICE JJSE: ;le r? ` " / 3 APPLICATION FOR SANITATION PERMIT Permit No. ....��.io ------------------------ -- (Complete to Duplicate) - - Date Issued ---------------------- This Permit Expires 1 Year From Date Issued Application is hereby made io the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. :I JOB ADDRESS AND LOCATION (1731) Gilchrist, Stockton ------••------------------------•--- �. ." -----------------------------•------------ Owner's Name-----------_-•... ---------------___ --- - ------------- Phone._...T3Q.. f27 Address-----------------------•--•--1732..5111 17,31,511trO----------------------------- -----------------------------------------.----------------------------------•--------.. --_--... Contractor's Name...........T�©---DAY• °&---N—T-GH'--3P_ptic.__=k-----SQr i-e�-----------••------------•------------ Phone._HQ..�z3$)1�.... Installation will serve: Residence ®' Apartment House E] Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ .I 1 1 Number of living units:-__--- Number of bedrooms2:__--_ Number of baths 2.__ Lot size __-"-------------1001--- ' Water Supply: Public system n Community system ❑ Private ❑ Depth To Water Table 0"_.. ft. 0 Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe EPHardpan ❑ Previous Application Mader'(if yes,date.--- ---------------} Ngf] New Construction: Yes No ❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: I r (No septic tank or cesspool permitted if public sewer is available within 200 feet.) RD W 94� Septic Tank: Distance from nearest well---Na?; ._._Dist ce fr m oundation__---��--........Material ---._------ -- ------ ... p � ��s ��jr1xQ"� tt $C3Q Ga is No. of compartments------ �------------------Siz -- Liquid depth--. 8.. Capacity t Disposal Field: Distance from nearest well_Norie Distance from foundatio 7Q_-_....""".Distance to nearest lot Live 51 Number, of lines-------3--------------------------Length of each line-------------.T--..----....Width of trench-....------------- -.--,��. _�-- Se Rkmaterial Type o�filter mafierial..._""P"-._" __"-"_Depth of filter ._-""�_: _"_"."�"Total ....."_"��'..�.-�-.-••5---- I�Ione Seepage Pit: Distance to nearest.well---"""_._-"" _ Distance from foundation_-_._Z�t..---.-.Distance to nearest lot line--------------- Number of its....: ___ Lining material"_.. _""-_".Size: Diameter_____ _ C epth______-•-- �____-•••=-•---••- �x r' ------ Cesspool: Distance from nearest well-----------------Distance from foundation--_-.----,--------.Lining materia_."."""""...__ --•-- Size: Diameter"------------------- ---------------Depth-----------------_•-•-----•----------------------Liquid Capacity ----------------9 els. ❑ 'I £ i Distance from nearest building _ Privy: Distance from nearest well- t ----•------ ❑ e to nearest lot line-_.,_.- ------------ ---•------••- --------------------- Distant _ r Remodel' and r re irl If t ng {describe}: "�� .. :•� " t liar e y e P I n-an a# t o Wil one in acc4o dna ce 4rith San Joaquin County ordinances, State laws, and rules and regulations of +he San,Joaquin:Local Health District. (Signed) The DAY & NIGHT Septic Tank Service "`-----"------- p� Contract 9 )---- .---- r or) 10 B I rifle r-- - ------------I- --- ' -----------------=-------- -------- -------------------- (rifle) (Plot plan, showing size of lot, location of system in relafion to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTE --- ------- DATE `� --- �--�"'- D BY------ - --� ----------- Y REVIE NG PERMIT ISSUE- ---- ----- ------------- ----- •- DATE------------------;------------------ ATE------------------=-------------------••------------------ D------------------------- -------------- DATE-------------------------------------------------•----------- Alterations and//or recommen atiorDs----------------- ----------------------------------------------------------------- - 4_� -- ------- -- 8f - ""'LJ"`-! "�--• '`adv-•--- c- - - -"-- --------- - '- - ----- z.^ Date--------1 - - ------------- ----------------•-------- r FINAL INSPECTION BY------�.--- � �_-----.�.? - SAN JO�Q N LOCA HEALTH DISTRICT 130 South American Street 0D-W*o-0ak.Std3t 14-Sycamore Street 205 West 9th Street :! ` Stockton,California Lodi,California Manteca,California Tracy,California I E5 9 REVISED 8-59 2M 5-62 ATLAS ,.