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APPLICATION FOR SANITATION PERMIT Permit No. ------ (Complete in Duplicate) — This Permit Ex f1 Y / ----------------------------------------------------- res Year From Date Issued Date Issued .5�/--•--�7i Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the wo�r�here ��scrl ed This application is made in compliance with County Ordinance N 54 . :4rP_ -c�J� r �Wesl* endofSch€�ol -- Lot JOB ADDRESS AND LOCATION--Halmar Heights — So. Of "N' St. — . L4throD. Calif. �riSt -------- - - ......._-•-----Owner's Name----P1�11� S•-G -------- ----------------------------------•-•------------------ - Phone. IQ._ -071Address.. 86+ Stockton.th S ---•- _ CaIif ------------------------------------•--• ---•---•------------•-------•-----.....-----• Contractor's Name-----The_- DAY &_•NIGHT _SeptiC 'Wank Svc� HO 6_3$x„ k---------- ---------•-•----------..-._..----------------. Phone..-•------..... 1 Installation will serve: Residence ❑ •--'"" ""'-'-"'"- ] Apartment House Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: .1---- Number of bedrooms .3----- Number of baths __1--- Lot size ._-_100 XOOt Water Su ...-------•- pply: Public system RC Community system ❑ Private ❑ Depth to Water Table _..----- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam MC Clay Loam ❑ Clay❑ Adobe❑ Hardpan ❑ Previous Application Made: (If yes,date- -------------_-) No 0� New Construction: Yes19 No ❑ FHA/VA: Yes ❑ No❑ TYPE OF INSTALLATIOR AND..SPECIFICATIONS:` (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest wellftl!!----_Distance from foundation 101r CC Brick M la! tf tf if �{ ---------------- Mx No:fof compartments-.. ------- - __Zq 3 depth----------------- ----Capacity 8b............ -� Disposal Field: Distance from nearest well_--H_QnPi._Distance from foundation - . s is nce to neeres lg llne._.�l._..-....- - ------ ]� Number of lines------- ----- --------------- Length of each line.__ E!_�_ __g_ of trench..- 4 _________ Type of filter materia.L. -eP-,_--Rt.De th of filter material-__-1�l- g �150�• ------ Seepage - ---------Total length Seepage Pit: Distance to nearest well----------------------Distance from foundation..........--_.......Distance to nearest lot line------.-.--.._- � ❑ Number of pits------------------_--Lining material_.-_-_--._- _---_------Size: Diameter--_.._-..---.- ----•---Depth--------- -----------••-------•- Cesspool: Distance from nearest well--------------- Distance from foundation. _ ----------------Lining material_.-.-----__--.__-_-- ---- • ---- -g---a--l-Size: Diameter---------- ---------------------------Depth-------------------••-------------------------------Liquid Capacity Privy: s. I Distance from nearest well------------------ ------------------------------Distance from nearest building Distance to nearest lot line ---- ---------------••----- --- •---- Remodelin and/o repairing (describe):•-- A_p ,_ WAS IN. t?-Ua5 "7—/_0� ,�, ----'W��-------�0MV.....-.0 - "f ------��----- .1D--•----/--77-.---W�7 �-� + .:t ------------- -------------------------------------- •-------- ---•-------------------•-----------------------••-----------•----------•--------------------------------------------------•----•--------------•------- Ti Q - h e ---- -- -------•--------------------•----•------•--------------------•-------•-•-----•---•--•-----...---••-----••-----•-----------•--- I hereby certify that hay prepared this application and that the A will be done in accordance with San Joaquin County ordinances, St ws, an rul s and ulations of the S Joaquin, cal Health District. ff . Si ned �d� _ t [ 9 } ------ �. Contractor] l BY: ------••-----------•-----------------------•----------------------••----- {Title} .----------•------- ------ -- (Plot plan. showing size of lot, location of system in relation t ells, buildings, c., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-._-_ --R-,-O-------------------------- - REVIEWED BY DATE , -5...` - ------ .-•------------ ------ DATE----------------------------- ------ UILDING PERMIT ISSUED._.__--_._-_•----------••,---------••- --------•------------- ---------- --- •----------•------ DATE-----•------------- AlFerations and/ar recommendations----------------------------- - , -:I: - - ------------------------ ----- ---- ----------------------------------------------- ---------.................... --------------------------------- FINAL INSPECTIO Date........ ---- S`: -----------------------••------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 9Th Street Stockton,California ES 9 REVIS Ea 8-59 2M 15-6t ATLAS Lodi,California Manteca,California Tracy,California