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IVRLJFVI%-.L UJL: ------------------------------------------------------ --------------------------------------------------------- APPLICATION FOR SANITATION PERMIT Permit No. .. 5. ----- ------------------------------------------------ (Complete in Duplicate) 5 -- --------------------------------------------------.--. This Permit Expires 1 Year From Date Issued Date Issued .._. 21 _`f....G.. �al� LEQ --02- Application is hereby made to the San Joaquin Local Health District for a permit to construct a In all the work herein described. This a 1'catio is made in compliance with County Ordinance 549. �' a s . J-f jq-t_ ,.-,2 �v. fest End of School - Lot 2 JOB ADDRESS AND LOCATIONHaLIM1 lr-__Height-s..__-- SO. -of "M" St . -- Lathrop. Calif. -•--- . ••------------------------ ---------------- . Owner's Name._._Phillips_Const• C'�• --- •----------------------------------------- Phone-HO_2=0713----- Address----- ----------- We 5th.-St r stock Qx1j 9a1.1f----------------------------------------------------------------------------------------------------- Contractor's Name-_-he---DAY—&-N11?1il..-5.epttD---TM7.k-..SYC.: •.............••-•---....•-•....--------- Phone.N..-6-341........ Installation will serve: Residence WX Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: _1---_ Number of bedrooms -3---- Number of baths J... Lot size _IOOt----X---1001... ...................... Water Supply: Public system ZK Community system ❑ Private ❑ Depth to Water Table ........ ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam MK Clay Loam ❑ Clay ❑ Adobe❑ Hardpan ❑ Previous Application Made: (if yes,dote--------------------) No ❑ New Construction: Yes [MXNo ❑ FHA/VA: Yes ❑ 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- None--_Distance from fou--ndatio _-_j10-t---_.---Mater ialCC Brick . ................ No. of compartments---- --------------Size _tf._-.x...361--XL � depth----5�tf----- •-------Capacity--- �d. gal • Disposal Field: Distance from nearest welIXOnG -...Distance from foundationl-Q�__ ____ ante to nearest lot line.-5 ____.._... Number of lines---2-----------------------------Length of each line...-____75 _�+E-..._�i th of trench... 1t--_______________._.___.... oo Type of filter materia e.p-.---Bli..-_.Depth of filter material_._-lV-----------Total length------- ;-_-..../t e�.�....-_- . Seepage Pit: Distance to nearest well----------------------Distance from foundation....................Distance to nearest lot line................. Dc�- ❑ Number of pits----------------------Lining material----- •--------------Size: Diameter----.-.----------------Depth............................... Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material---------.__..,......._..---_------. y }� ❑ Size: Diameter.-----------•-------------------------Depth---------------------------------------------------Liquid Capacity----------------------------gall Privy: Distance from nearest well----------------------------------------------_Distance from nearest building........................................ ❑ , Distance to nearest lot line---- -------••-------------------------•------------------------------ -----------•--•-••--•---•-•----------- Remodelingand/or repairing (describe):-----------------------------------------------------------------------------------------------•-----•-------------•--•---------•----•----------•------ ------------------------•••-------------------•-----------•---••-----------------..--....---------------------•----------------------•---------------------•------------•------....----......-----•------------------------ ------••---•-------•------- ---------••-•----------........------------•-----------------------•-------------------------------...----------------------------------------------------•-------•------------------•----• -- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State,46ws, a rules and regulations of t e San Joe Local Health District. - . . t �` -- -(Signed)--,/ ---------- - -- -- f ----- ------- ---- -------- ---------------------•------•----. r Contractor) I� By:--------------------------------------------------------------------------------------------- ---=---------- � ...(Title)--- -- (Plot plan. showing size of lot, location of system in relation to ells, buildings, a ., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-----T-R.P'-------------------------------------------- REVIEWEDBY------------------------------------------------------------------------------------------------•--------------------------._ DATE BUILDINGPERMIT ISSUED--------------------------------------------------------------—...................... --------------- DATE. Alterations and/or recommendations:------------------------------------- --------------------------------•-••--•-------------------...-----..--....----....-------------------------•------•------ --------------------------•-•------------• ------------------------•------------------------------------------...-•---•---•------------------------•--••-•--•---•-------...._.--------------------------------------------- ----------------- FINAL INSPECT Date...... -- '-b-7-------------------------------------•------ SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California ES 9 REVISED 8-99 2M 5-61 ATLAS