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ordinances, State laws, and rules and regulations of the San Joaquin Local Health District.' <br />I hereby certify that I have prepared this application and that the work will be done in ac.cordance with San Joaquin County <br />FOR OFFICE USE: <br />APPLICATION FOR SANITATION PERMIT Permit No. <br />(Complete in Duplicate) <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 and install the work herein described. <br />This application is made in compliance with County Ordinance No. 549. 2_ 3 ,j-c( A/. <br />OCATIONS-0140-c2it 0.41411 <br />Phone <br />Contractor's Name . f‘lere'rr'i.:4•• Phone <br />Installation will serve: Residence Et' Apartment House 0 Commercial 0 Trailer Court D Motel 0 Other 0 <br />Number of hiving units: I Number of bedrooms 5 Number of baths 7"- Lot size I <br />Water Supply: Supply: Public system 12I Community system 171 Private Elf Depth to Water Table ft. <br />Character of soil to a depth of 3 feet: Sand 0 Gravel 0 Sandy Learn 0 Clay Loam 0 Clay rAdobe 0 Hardpan 0 <br />Previous Application Made: (If yes, date ..... __ .. I No 0 New Construction: Yes 0 No 0 FHA/VA: Yes T1 No 0 <br />TYPE OF INSTALLATION AND SPECIFICATIONS: <br />(No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br />Septic Tank: Distance from nearest well --r° Distance from fouidation /JD ' Material C.e/2.44 <br />No. of compartments 7-- Size 1,1-/.‘ ":41 'Ai S ' Liquid depth q " Capaci ty..../.e.et <br />Disposal Field: Distance from nearest well $'O' Distance f <br />, <br />-from foundation /V Distance to nearest lot line_5 <br />Number of lines 4 Length of each line8r-&g -.5:0C22Width of trench "2-1 <br />Type of filter material ,,,i. te... Depth of filter material.. 1_.9 " Total length ..4 a ' <br />Remodeling and/or repairing (describeI• <br />Date Issued OS <br />JOB ADDRESS AND <br />Owner's Name <br />Address <br />Distancen foundation .I..0_ / _Distance to nearest lot line...r / See7 Pit: Distance to nearest well .1/20 1 fr <br />Number of pits '7— Lining material._ Size: Diameter )7'' Depth_ .c9 .9 ' <br />Cesspool: Distance from nearest well Distance from foundation Lining material <br />0 Size: Diameter Depth Liquid Capacity gals. <br />'7 <br />Privy: Distance from nearest well Distance from nearest building <br />0 Distance to nearest lot line <br />(Signed) <br /> <br />By <br />(Plot plan, showing size of lot, location of system in relatio <br /> (Owner and/or Contractor) <br /> (Title) <br />to wells, buildings, etc., can be placed on reverse side). <br />FOR DEPARTMENT USE ONLY <br />APPLICATION ACCEPTED BY <br /> DATE -krtr. <br />REVIEWED BY DATE <br />BUILDING PERMIT ISSUED DATE <br />Alterations and/or recommendations: <br />FINAL INSPECTION BY; Date 6- 2 4, <br /> <br />... <br /> <br />SAN JOAQUIN LOCAL HEALTH DISTRICT <br />E. Hamilton Aro. <br />Stockton, California <br />ES 9 REVISED 8-59 31/1 3.'63 F.P.CD. <br />300 West Oak Street <br />Lodi, California <br />124 Sycamore Street <br />Manteca, California <br />205 West 9th Street <br />Tracy, California