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I FOR OFFICE USE:. APPLICATION FOR 4ANITATION PERMIT Permit No, ..4.17-- (Complete In DWgcO*) Dote Issued ..... a�b� _ This permit Expires 1 Year'From Date Issued ,A,pplicntion is hereby mode to the San Joaquin Local Healfh District for a F:, mit to construct and install the work heroin descrbed. This application Is made in comp!'er,:e with County Ordinance No. 549. JOB ADDRESS AND LOCATION. _..��..�� _` .r�....... . �. t.�Y�f%.H..1...................`.......... . ....... ................ .......... Owner'► Name.._ _ ��. .. kV_C)W.. .............................. ...,.. ......... ........... . ..... to Address.........................._ vv-..c...... .... .. ..................... ........... _ Con+rector's Nnme_. 1.NO....._.....:................1............ Insfallation will serve- Res;dencn Apartment House [3 Comrnereial ❑ Trailer Court ❑ Motel ❑ Other ❑ o Number of living units: . Number of bedrooms Z... Number of baths .q , Lot size,.74...... X..Z,.►1..CQ.................... Water Supply: Public system [] Community system ❑ Private Q} Depth to Water Table Yto. ft, Character of soil to a depth of 3 fest: Sanj[] Growl❑ Sandy Loam❑ Clay Loom❑ Clay(-] Adobe eff Hardpan❑ Previous Application Made: (if yes,cata�i �.�:.-) No (]•. New Construction:.Yes Q Ne, CR FHA/VA:Yes❑ No J9 TYPE OF INSTALLATION AND SPECIFICA FIONS: (No septic tank or cesspool permitted If public sewer k ovellable wlthln 200 het.) Septic Tank: Distance from nearest well...............Aistanee from foundation...................Material— � .. ❑ No. of compertrse sfs............._...... $126................................Liquid depth................ ........Capacity... ..._...--.._.._. S Disposal Field: Distance from nearest well. �%Q 104stanee from foundafion.• ,Q-„r .,.Distance fo+narost lot line.... Number of lines. ........../..........:.........Length of each row..........SJ....t......Width of trench.......... _"........... Type of filter material_!,A0PiC.*.._....Depth of filter length............... �.6f Seepage Pit: D'.0ance to nearest well ,IQQ..�....Distance kom f*�ndetion-.__!-Q_1.......bistence to nearest lot Gns....4-•• --„ I9 (.'umber of pits ...- .f..........Lining ..Size: Depth..........;?.%$.........._„ k • Cesspool: Distance f om nearest well...............-Distance fear founrf;aiion...................Lining material................................... ❑ Size: Diameter. ._. ........................ th..........._._...._..............................Liquid Capacity......................._._..geh. Privy: Distance from rearest well............. .....,.. .».,..,,.„....... D'I:tanu from.pearts` building--,,-. _ ......r____------------- O Distance to rearrest lot line..y ~ aRemodeling and/or repairino ;describe):.. .....- 1� -.„ ._ (.iC/1� ._r'fl ft. !!!►'.. ......................._-- •...............-.......... ..........-.......„„....._...«.............. i.„..».•-•••'-...-._._....„...............................__.- .. ....._........I—......... r .. .................._._.-......-.................._.__.._..._.........„._._.w.............. ..._.«..__„....„_«.„_�.._._..„...___..._.__..........._•__•_»___._-__�_'__-.._._......__................... t 1 • F I heroby certify that I have prepared 6;s application and the#the"Wk'M be done In accordance wf fan Joaquin County ordinances, r:.,te iaws, and rules and :egulations of the San Joaquin I” Health District. 's (Signed)•......... '.:.f �/.•...r' __.. _4A -___...o r�.�r.................... ..................( and/or �;wtreetor) L .-.. ...-. ... (Pbt plan, showing sits of lot, locefiors system in relation to web. butldtrsgs, or, can be plead on reverse stile). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED b•r / Li'...! . ...�i....!:7--.........._................................. DATE... ,fes. .. - REVIEWEDBY..... _ .... . _ _ _ _.............................................._................................... DATE....................................................... „. BUILDINGPERMIF ISSUED ... .. . ...... .....j.._ ..__............_._.;.......__».._...............__.-.._.......... OhTE.-..........-......_............-. ..............._ .. AHeretions and/or recommendations:_.., z't .s-.� .es cx:<.. .r..1•c...et+4'......./tine.:.f.....�.. ......r`.x: ..................... �� _.--.... --l ........................................................................................_......._..__... i ...�!-7r[..i Wil. �./�...-. .. ... -._.-._ ................ ....... ................... .. 1 . .......................................................••...._............. ............................._............... ...................... FINAL INSPECTION BY:,/-/. «..!.`�:............... -4 SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 1.Ma»hen Ave, 300 West Oak Street 121 fycomwe strut 205 Wee►91h Shaw fteckre ,tallleia Lsdl,Gallternra Mant•ce,Catl4mla Tracy,Gllenla r 4+-