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- y � t`. Permit No. APPLICATION FOR SANITATION PERMIT / l },. `? I igate Date Issued •---• Y _ (Complete in Dupl' � 7q-,,9�_` DS9-�o-�-1 _ permit to cons#ruct and install th ork h described. I/ Local Health District for pe App is hereby made to the San Joaquin F _ I This application is made,in compliance with County Ordinanc,� No. 54 . ��'' 11 f_- CATION_____--- ` --- ---- Phone-------�i JOB ADDRESS AND L --------- - ------- ----- -------------- _ ------ - --------- r -- - ---- - '�!rOwner's Name---t----- � - �.;..._,�- ---, _ r -------- - -- , Address--- - - •------- ------- ------------------- - ---- Other ❑ + Notel ❑ Commercial ❑ Trailer Court [] Contractors Name--------------- Apartment House ❑ -----------•---------- ' Lot size --- - - Installation will serve: -Residence i' Number of baths -- Y Number of bedrooms 11� ft. Number of living units: -- private Depth +° Water Table Adobe, Hardpan ❑ I Community system.❑ ► lay Water_ Supply: Public system❑ Gravel ❑ Sandy Laam ❑ Clay Loam ❑ IYfO F - No Character of soil to a depth of 3 feet Na and'❑New Construction: Yes ` lication Made: Yes ❑ ' Previous App ublic sewer is available within 200 feet.] , TYPE OF INSTALLATION AND SPeCmit edT{ONS: (No septic tank or cesspool p i f #•e- r}-�__;Distance from foundation_-1-��----------�Materiai_�-•-----�'---- --~--- � P m.... .�., ' n- ----Capacity: Distance, from nearest we41_ - - _ Septic T i: -- S�. _�j_Liquid depth----:'- - Size- r-`""- d No of compartments__.---,�------- -- -- I tance to nearest of line_-_ -----• /, r�(� Distance fro�ri foundation_._--:-•. 1 Distance from nearest well-/----- _ S'a'----_-_-.Width of #ranch.-- pisposal .field: Length of each line---------------------- Length lines-- --- -------- / Tota4 length_.--_--- � �e th of filter m serial,_ 11- Type offilter materialLsr-P_ p 4 Q-�.-.Distance to nearest lot line_---�--------- Distance to neatest well-_f Distant m fou ation___ _ .� , it: Lining material------ Seepage .Size: Diameter Deptn-- �y Numberof pits---- gals. O Liquid Capacity- Distance from nearest well---------------'Dist+hce from foundation=.-.---_-------.L�ning materia ---------•- --------- ----------- -- } Cesspool: --'De -[ Size: Diamefer- _ "� Distance from nearest building-------------------- ----- ❑ ------------ "---------------- �. Priv Distance from nearest well- ------------------------ ----- --- ------ --------------------•-�----------- �. y.. ❑ - -Distance to nearest lot line_'-------- ---------------------- El ' _ -- - - J . ------------------------- ---------- ----=---- -------- Remodeling and/or repamng (describe): ----------- -•_.--•-----•-----`-----•----•--•-•---•-------••-----•-•-•-------------- ------- =- _= ---------------------------------------� ------------------•----------------- _ ----•--•---------------------------application and that the work will be Bane in'accordance with San Jaa uin County q - ----•-- -------------------------- --red this app I hereby certify that I have prep ' ordinances, a laws; and rules�regulaftlthe San Joaquin Local Health Distrl V,----,,Owner and/or Contractor) Si ned (Title) -------- ----- ( 9 _______________ _ _ V buildings. can be place an reverse By:._.--------•---•--•--�- - --- stem in relay n to wells, etc., (plot pian, showing size of lot, location °f sy FOR DEPART ENT USE ONLY s DATE _---�--------- ----- ---------------------------------------- DATE....... ---------------- --------_---------------ACCEPTED BY----------------------------- . ----- -------------------------I------------------- DATE--------- - REVIEWED BY---------------------•----------------------- - -------------------- �f --------------------------------- BUILDING PERMIT ISSUED._..._-.-- --------------- . - ----------•-----•----•- __ _ Alterations and/or recommendations----------------- { - -- .--- ------ - �. '- -- - - -- - ----- --- - ----------------------------- ---------- 9------------------------------------------------ ---------- ------ -----------------------I--------------- ------------- ---------- ----------------------------------------------- ----------------------------------- ---------------- ----- FINAL INSPECTION BY:. JOAQUIN LOCAL HEALTH DISTRICT 814 Horth ,.C" Street 360 West Oak Street 132 Sycamore Street Tracy, California 130 South American Street Lod;. California Manteca, California Stockton, California