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"IT sof <br /> •` "�cy'►r�'�iid� d� . .. fi ��-xf �Y. � :n .F .. A Y <br /> wMs+�-• <br /> ot k '� <br /> ::r � .k'Nww4�r.-:^M4.a�4ert�'rr+�'�esX?:.i:•:.�i:�'.hfrk` -.,�� <br /> \ i <br /> APPLICATION FO R SANITATION PERMIT Permit No. .!.�_.1-.4..}- ' <br /> `Camplefe in Duplicate) % <br /> `}71 Date Issued ..g........... ..... <br /> This Permit Expires i Year From Date Issued <br /> Application is hereby made to the San Joaquin -ece' Health District for a perm!+to construct and ;r,-ta!I the work herein described. <br /> This application is mlde in compliance with�jCounty Ordinance No. 549. <br /> JOB .ADDRESS AND 1.0TIO .-- .. ....E�.... 6/iPlr' '.........................................................-....---._------••••--••••--•- <br /> Owner's Name........... - <br /> ..... � Phone................................... <br /> - _ <br /> 4' <br /> Address-_._.---- --•-_-.70���• ✓G2� ��:-�....--.. L-�.......... ................................._ ........_-..--...._....--...-_.._........._....._... <br /> ys i ' <br /> Contractor's Name-.................... T...�.... GS .......- -...........- Phone----..........-..... ............ <br /> Insta!la+ion wiii servo: Residence E] Apartment House ❑ Commercial Trailer Court ❑ Moiel ❑ Other ❑ i. <br /> r3 <br /> Number of living units: Number of bedrooms -.^.... Number ct baths ..C...- Lot s,ze /.... '_�..,.'r16�7. ' <br /> R <br /> Watcr Supply: Public system [ ommunity system ❑ Privets ❑ Depth to 'teeter Table res eft. <br /> Characfrr of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam❑ C!ey Loam❑ Clay❑ Adobe 12-`I'iardpan❑ <br /> i•°i i Previous Applieefiion tv!ade: Yes ❑ No Z�'�Ncw Construction: Yes R No ❑ FHA;VA: Yes❑ No 2;--- <br /> TYPE OF INSTr.LLATION AND SPECIFICATIONS: K <br /> �g (No sops tank or cesspool permitted if py i Ver is available within 200 f,�et.) / <br /> i Septic T nk: Disiance from nearest .e ... ,.�!..Gatance_from foundation..!i.......... <br /> G -...- <br /> j No. of compartments.-.. .............. ......Liquid depth_. . Capecity.. <br /> Disposa'. Feld: D-,fance from nearest well. ....—'- C dance from foundation--l�-�____..Distance to neerest lot Iine..f�T.�._. u <br /> ( :umher of lines-.-. ..I/ length of each line... f1�....... .......Width of trench...' ..........._-.... <br /> Typo of filter material -,L. GCI4.De�-fh of fifer materal..... ...... f ry <br /> ' fl-- - �.,tT t I 'ten t �0---._.--•...............•- <br /> h <br /> Seepage it: istance to nearest well..._ """'.--.-.-Distance from foundation---.�0..._-_.Distance to nearest lot line_...Jr..�......._ U• <br /> ��4xs <br /> of pits.....................Lining material•.Xe� ..S ze: Diameter.. �!i [)e th..-...i�f' <br /> .��........_-. P <br /> 1�r <br /> S <br /> : Cesspool: D'stenLe from nearest well.................Distance from foundation.-................Linirg malerial..................................... 'fa <br /> ❑ Size: Diameter.....................................Depth. ............................---._.-..-.....----Liquid Capacity............................c)Is. <br /> . <br /> Privy: Distance, from nearest well-..... ........................................Distance from nearest building ..._................_................ � <br /> ❑ <br /> Distance fp n,mrost lot line................. .. ... <br /> i Remodeling and/or repairing (do:tribe):............ <br /> C/✓.-... �fi�+'✓...................................................._................ <br /> 24 <br /> .............. � � .................................... <br /> q YrrT <br /> L� V <br /> 1 .... <br /> .. -�r.................................................................................................. ..................................................... <br /> hereby ' tify that I havo pr4pared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, Rioe laws, and rules and regulat,ons of'the San Joaquin Local Health District, <br /> 7 ; <br /> ............(9=90=1MIAs Contractor) <br /> ...• I ISI ne.f .............�l,�. �.-.... ,,,.. <br /> r+I c) ce✓....... ._ . .... ........ <br /> t. l (Piot plan, showing size of lot, location ors min relation to wells, buildings, etc., canr_e placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY <br /> VV ......-..-................. <br /> ............................•-•-.- DATE........5-'.4..p -LT...._-........ <br /> .... <br /> � . <br /> REVIEWED BY_.-...- � �.... DATE...............•--•....................... .......... <br /> BUILDINGPERMIT ISSUED.............------`.�..-------------------------------------------••----_-.__-._-.-...-....-....__ DATE - <br /> Alterationsand/or recommendations:.._..- ..................• ............._-•--_-----------------------____.-_•------.------••- --•--••-•-----.---_•----•--------•-------•-------_ i• <br /> 1 � <br /> ---------------------------------------------------------- <br /> t„ <br /> C t fig <br /> ✓.-..w.... ............ . ....................... ........._r. .-..-.-......-........-._..------------••---.......-....................................... <br /> r <br /> ...9a"F' a .: <br /> r.: FINAL INSPECTION BY:....-....Zl... ........ ..-_.- ------------- Date....... .......+-'.�-_--�rv?.............................................. � • <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> rLL <br /> 130 Sou`h American Streef 3DO West Oak Street 132 Sycaaore Sfraef 814 North "C"Strwf <br /> Stockton, CaCForn;a iod% Caliiornic t.i40eca, COVOrnla Tracy, CaliforniaM11 11 <br /> F, i <br /> �As7..:�•{•+1 <br />