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-9 . <br /> FOR OFFICE USE: Je z �% 1 <br /> �-7 A <br />---- ---------- ------ --------------------------------- <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br />----------------------- -------- -------- ------------- <br /> ------- ------ --------------------------------- (Complete in Duplicate) Date Issued .3; <br /> ----------------- This Permit Expires 1 Year From Date Issued <br /> ll <br /> -------Appi c!6i 7 1 ion is hereby made to the San"Joaquin Local Health District for a permit to construct and 'install the work herein described. <br /> This al3picatiort is made in compliance with County Ordinance No.. 549. <br /> I—Al ...... <br /> ADDRESS AND LO ... .. .......�­---------------- --­1117H.F�x <br /> ............. <br /> joB A CAT 10 N. <br /> Ownerts!Name__..--------- L-P ­.......C-0 msT- , Co ----------------------------------- Phone..................................... <br /> -37 > ....................... <br /> Address--- ­-,?,.�jQ3-BQY--------- ...... 40 <br /> --------------------------------------------- <br /> --------­---­---------- <br /> Contrdctor's Name.m-T-V1z0RF,--&-:t------ - <br /> -`jr -17[3`0-flier 0 <br /> 1P -t�woqmerelaqj T, re�rCou� ofe. <br /> Rp—arfff4rit-Hou, lrai <br /> esi ence 7e Li <br /> Installaflon will serve; I * <br /> C Tunits; Number of 6edro 6 <br /> ,'Number of iivinc ------ omq 3---- Number of bats �� Lot size !PW-J00-----------------------------­- <br /> ! t I T Water Table .,I-- ft. <br /> Water Supply: Public system Community system 0 Private 0 De t I <br /> Charactfttr of soil to a depth of 3 feet: Sand eGravel [I Sandy L M.Wlay Loam o Clayo Adobe[] Hardpan [:] <br /> I i ) NoOET-' New Construction: Yes RQ-1No I-] FHA/VA-. Yesoer'No El Nl� <br /> Previous:Application Made: (if yes'date_-- ------ ------ <br /> -000 <br /> 'UIZWSTAL - Tidk�AND-SPECIFICATIONS: <br /> -WPIE CA <br /> (No septic tank or cesspool permitted if public sewer is available within feet.) F <br /> i It I 'r <br /> ce from foun a i6n,­10........Mateirial---"COMC45IF- ­4_�-------- <br /> Septic1l;,ank: Distance from nearest welldifAff-F-Dist, <br /> No. of compartments--------'2---------------Si-ze__,j J <br /> X <br /> S-.-Xiquicl,clepth..... ------Capdcity­/P-q-c..... <br /> I V 5 <br /> Z42-----.-...Distance to nearest lot I;ne---, <br /> Disposal'.Field: Distance from nearest weAAAWWF—Distance from foundation <br /> Number of linesA Length of each line.-VA4n 0-----Width of trench------9-6---7--------*---- <br /> Number <br /> of filter materZIA.1 --------Total 'length--.,­- -•------ <br /> " Type -�O< <br /> Type of filter ma <br /> 711 0/1 e I I Dis"N" e from founclattin_____________•__-...Distance to nearest lot line___-_______.___._ <br /> Seepage Pit: Distance to neare <br /> Number of pitsf-----------------Lining mftgr4al---N*%�------------Size: Diameter-------------­---------Depth--------------------------------- <br /> f <br /> 'rD'jtn- nom f*3uhdat!;- --------------------Lining material____..________..______..-_..____.._._ <br /> arest well........ ;15 anCe,' on <br /> Cesspool: Distance fro e it <br /> ,'n & ;W 'A* -------------Liquid Capacity. gals. <br /> -------------- <br /> Size: Diamete - ------------------------- ----7----De <br /> p [Prstance%1Km nearest building------------------------------------------ <br /> Privy: Distance from n`enr1he'%fi<ell----------------------------------- <br /> ❑ <br /> Distance to nearest lot line,---- -----------------------------------0-------------------­---- -----------•--- ------------------------------------------------- <br /> -----------------------------------­------------------------------------ <br /> R mod�ling and/or repairing (describe):___-__._-._____.___.__-- ---I----------­----------------------- <br /> I .------------------- ---------I-------------------------------------------::-------- ----------------------------------I---------- -------------------------------------------------------------------- <br /> "b"`I-------- <br /> I ; <br /> . ­­---------1-------------- ------------------- -------------------------------------- <br /> ----------------- ..I--------- <br /> ----­------------I------------------------- ..........-------- ---------------/--------------------------------------------------1-------------------------------- <br /> -----------1.11-------------------------------------------------------11-1--------------*------I------- ..!�b, will be done in accordance lith San Joaquin County <br /> I 'hereby certify that I have prepared this application and that the jj(1A, <br /> State laws, and rules and r I * f the San Joaquin Local ealth District. <br /> .�qon s C <br /> ordinances, <br /> {Owand/or Contractor).- <br /> ----------------- - 7.. <br /> .. ...... ... .... <br /> (Sigped 1)!--��- 7k-1------- <br /> -------------(Title)--------------------------------------- ----- - ---------- <br /> --- - ------ --- -------- ----------­- - <br /> B�:..........------------------------------------------------------------relation-- - to--wells buildings-. etc., can be placed on re use side). <br /> (plot pidn. showing size Of lot, location of system in <br /> P.120 irr IWEPARTMENT USE ONLY <br /> TE-------- --- ---------------------------- <br /> APPLICATION ACCEPTED BY-------4 IR200,- ------------------------------------------------------------------- DA <br /> - A ---------------- DATE------­--------------------------------------------------- <br /> REVIEWEDBY_-------------------------------------------------------------------------- --- ---r_ —- <br /> I"------------­­--------- -------------------------------- <br /> -------- ------------------------------------------ VY,94).rn------510(ST H------- <br /> WG Z;� <br /> BUIUDI -PERM'lT-I8SUED­'-A <br /> I -9797---F"A-- ---------- - ----- <br /> Att�rair,t,s—,n�—/,r*or�e-c-omrnenctaf ionsi-7--35 'It <br /> il *W c wz !�i---------qK ----------------------------------------------- <br /> .........-!-A---------------------------------r-tj----------- -------- ----------- <br /> -----------!J---- ----------------------------------------------------------------------------------------- --- -------------------------------------------....----------------------------------------------- <br /> .4 1 �� /I ---------------------------------- ------------------------------------ --------------------------------- <br /> -------------------------- ---- - --- --- ---- -- -- ------V----)---- ----- ------- --------------------------------------­ <br /> - ------ -------------------------------------------------------- <br /> ------------------------------------- -- --- ----- <br /> -ym��7 Date__--------- ----------------------- <br /> FINAL INSPECTION BY: <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> ES 9 nEVIsED a-59 2M 542 ATLAS <br />