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APPLICATION FO. SANITATION PERMIT Permit No. ._;!__l--_9 .-__.. (Complete in Duplicate)Q 91�G y Date Issued ._-,/- .�_2--- 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. . t� 14.E X - JOB ADDRESS AND LOCATION__�fjhVeen 6th St. do 7th St. o.R °J" St. , in Lathrop, Calif. Owner's Name 1-J n--and_-B e_21Veia-fd8--�.------awx g-,------------ --------------- --------------------------- Phone- HO•--=-3---49q�9------ Address---------------P-&---4...... 7a hflop------ ne�lghbOr _ ------ T � Phone._ iContractor's Name--------=-DSetk Service,ce --- n0. Ho. 3-7727 % Installation will serve: Residence ® Apartment House ❑ Commercial ❑ Trailer Court'❑'-Motel 0 Other ❑ Number of living units: 1____- Number of bedrooms 2_____ Number of baths .l____ Lot size ---__._ 0---x__-75_______________________.____ 1 Water Supply: Public system ❑ Community system ❑ Private ® Depth to Water Table Zd� ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam4], Clay Loam ❑ Cay ❑ Adobe ❑ Hardpan ❑ Previous Application Made: Yes ❑ No ® New Construction: Yes ® No ❑ FHA/VA: Yes ❑ No ❑ I TYPE,OF—INSTALLATION:AND. SPECIFICATIONS:_ {No septic tank or'cesspoo) permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well-----------------Distance from foundation___________________ Materiaf__-_______________.-- _._.__.___________,--. . ❑ No. of compartments--------------- ------ ---Size--------------------------------Liquid depth---------------- ---------Capacity---------------------- Disposal Field: Distance from nearest well_________________Distance from foundation--------------------Distance to nearest lot line.-------._______ ❑ Number of lines---------------------------------.-Length of eachline------------------------------Width of french--------------------- ------------ Type of filter material-----------------_---------Depth of filter material-------------------- _.Total length-----------------------------__\______- Seepage✓ Pit: -`Distance'fo nearest well --- ----------------Distance from foundation--------------------Distance to nearest lot line------.--___.--_.O ❑ Number of pits----- ------Lining material----------:------Size: Diameter------------------------Depth_. --------------------------- Cesspool: Distance from nearest well-_.__�.QQ__Distance from foundation......10--`___�Lining material__ _ ___I----------------- Size: _______________Size: Diameter ��------------ __:Depth _f0_'r,.).------------------Liquid Capacity :--599----- --------gal§j. Privy: Distance from nearest well ._r___________________________-_.____...._-__Distance from ,nearest building.,-__------------------------------,____._. ❑ Distance,to nearest lotline----------------------"------- -- ------------ ^ .:- Remodeling and/or repairing (cle'scribe):-------------I g alZing-_-q- cement cee�pool--to replace wooden -------------------------------------------------------------=------------------ -•----------------------------- =-----------=-- -------------------------------------------------------------- . --------------------------------- ..------. t ; } -... , - ----------------------------------------------------------------------------------------------------------------------------------•-- -------------------------------------•-----------------------•---------------- I hereby certify that l have prepared this application and`that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. (Signed)-------------Delta- 4ep-t1a--.T-izAX___Se.7 vl—c-e4-- 1110..-1------------ --------------------------------------{Owner and�or Contractor] _ _ By=-----------P e ` '3r ----- - r {Title} en; Y (Plot plan, showing size of lot, location of system in.relation to wells, buildings; etc., can be placed on reverse side). ,,�/ „FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BYJ - ----• 1-'-:5V :. DATE I REVIEWEDBY----------------------------------------------------------------------------------- ------------------------------------------ DATE--- t------ BUILDINGPERMIT ISSUED----------------------•-------------------- --------------------------------------------------------- DATE------------------------------------------------------------- ] Alterationsand/or recommendations---------=---------------------------------------------------------------------------------------------------•------- ---------------------•--- ' ---------------------------------------------------------------------------I- -------------------------------------------------------------------------------------------------------------------------------------------- 1 --•-------------------------------•------------------------------------------ ------------------------------------•-------- -------------------------------- ----:-------------------------- ------------- - FINAL INSPECTION BY: - Date ------------- -------------------------- � SAN JOAQUIN LOCAL HEALTH DISTRICT j 130 South American Street 340 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California < - . Lodi, California Manteca, California Tracy, California ES-9-2M Revisea 1.57.f.P.CO.