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SANITATION PERMIT Permit No. ..jl.'} . 1 y 'APPLICATION FOR SANT (Complete in Duplicate) Date Issued ------ This Permit Expires 3 Year From Date Issued _Application is hereby made to 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. - JOB ADDRESS AND LOC TION_ . _. ®. _e Phone ------------- Owner's Name-------------------- - -- Address------------------------ - Contractor's Name------------------ J ----------------------�- - ---------------- --�--------�--------•- ----- Other ❑ Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court El Motel ❑ w� r Number of living units: __- _- Number of bedrooms --.I... Number of baths ---1-- Lot size Water Supply: Public system �mmunity system ❑ Private El Depth to Water Tableft. Character of soil to a depth of 3 feet: Sand F1 Gravel El Sandy Loam F1 Clay Loam El Clay ❑ Adobe ardpon C] Previous Application Made: Yes ❑' No g?--_New, Construction: Yes [9--jqo ❑ FHA/VA: Yes JK�—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 --------Distance_from foundation----1_----_-----_.Material_._._ -- ---------- ---- +. ❑� .. --✓]`.- - Li uid de th_-. Capacity--- pf�].---- No. of compartments--------r�--------- Size - 129------ to nearest lot line---�•---.---- Disposal Field: Qistance from nearest well...- ---- Distance from foundation__..- Width of trench-.-_. �.1---------------- --- ' ❑� Number of line ----- ------------ -G- Length f each line---:_____-- -Q ------------- Type of filter material_�_��C!!�epth of filter matenaL_._/f�,-----Total length---------�r✓---�------ ��--___.-Distance from foundation---_•_-_----_:_---.Distance to nearest lot line_ Seepage Pit: Distance to nearest well_______________ `Size: Diameter__,. -- ------Depth-- --•--- , �/ Number of pits.-----/-------------Lining material-/C _j/ - ng Cesspook: Distance from nearest well-----------------Distance from foundation-------------------- Liinuid Ca ecit gals. G ----- 9 Capacity Size: Diameter-=----- -------- -------- -�------ ---Depth------------- -�-------------- ------ ----- fDistance from nearest building------------------------- i Privy.- Distance from nearest well- --------------------------- ---_-------_-. ❑ ________________ __------------------- ----------------- Distance to nearest lot fine____ Remodeling and/or repairing (describe)------------------ - ----------------------------- ------ ---------------------------------------------------- -1-------------------------------------------------------------------------•--------------------------------------------------------------- --------- e work done i I hereby certify thatI havespandr is aegulati ns olcation and that f the San JoaquinhLocal HealitheDistrictn accordance with San Joaquin County 1 ordinances, State laws, an - ----------------------------------- (Own 9r Contractor) (Signed) . ---------- - � --------------------- Byside). ( � ) (plot plan, showing size of lot, location of system relation to wells, buildings, etc., can be placed on reverse FOR DEPARTMENT USE ONLY --7 I APPLICATION ACCEPTED BY-_I---r`K C�.----- ----- DATE------------------------------ --------------------- REVIEWED BY--------------------- ----- ------------------------------------------------- ---- �---------------- DATE------------------------------- -------- ------------------- BUILDING PERMIT ISSUED--------------------------------- -------------------------------------------- - Alterations and/or recommendations:------- ----------------- -------- -------------•----------- -----------------+ -.•2 Z— ---------------- 1_ ...__0:Itf �K.- Via'------ --- ------------f-- --------------------------------------------------------- ------------------------------------------------------- - ------------------------- - - -------- -----••------ ----------- ------------- ----- -------- -�----�--- -------- ---- =---------- �- - ----� • - --�--- - --------- ---- - �� --- Date.--..J�-. �-�-�-4-�� --•--� �----=-.----�----�- ------------- FINAL INSPECTIOt�1�BY--- - - - ------ - -- ----- --------- SAN JOAQUIN LOCAL HEALTH DISTRICT 300 West Oak Street in Sycamore Street 914 North "C" Street 130 South American Street Manteca, California Tracy, California Stockton. California Lodi, California ES-9=2M Revised 8-'59 EP.Co.