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FOR OFFICE USE: --..---- Permit No. .f7` 5 APPLICATION FOR SANITATION PERMIT (Complete-in Duplicate{ Date Issued --------- -------- --. _---.4 -"--__.-_ -" - This Permit Expires 1 Year From Date Issued 007— Application is hereby made to the San Joaquin Local Health District for a pert `const and install he�� herein described. This application is made in compliance with County Ordinance No. 549. m.� •�- �_ JOB ADDRESS AND LOCATION Ga/1 - --------------- Owner's ---- .Owner's Name- - -------- --- - /� •--•- ` ' ISO- .�_4��a��_��_.. ��---"�-----• Address_��.A/& ��`j - --------- t ........ Phone--- Contractor S hone---Contractor`s Name_/_.-_.._- _----- =j 1� �G' �n Installation will serve: Residence 1�1 Apartment House El Commercial ❑ Trailer Court ElMotel ❑ Other El .. "" Lot size -------------------------- Number of living units: __1.. _ Number of bedrooms __ --- Numb Water Supply: Public system El Community system El Private er of aths-.Depth to Water Table ------ - ft Character of soil to a depth of 3 feet Sand ❑ Gravel ❑ Sandy Loam Clay Loam El Clay ❑ Adobe❑ Hardpan C] New Construction: Ye� No FHA/VA: Yes ❑ No [IPrevious Application Made: (If yes,date-_ 1 No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: �} ( P able within 200 feet.] No septic tank or cesspool permitted if public sewer'is available foundation________________ ___Material ----------------- ------------------------------ - W i Distance from nearest well-.........- Distance from Capacity_..___..___- Li e No. of compartments.---- ------------------Size------------- ----- -=- -------Liquid depth ---- -- 10 ` D• osal field• Distance from nearest well..__.._Distance from foundation----/P"."----.Dis#ante to nearest lot``line_________________ __Length of each line' "�"�S r „ 'Width of trench__,;-2—�� ------------------ Number of lines ........... ....._ g d 1 f� -�` De th of filter material---- Type Total length_,cc- ----------`f'----------� - d� Type of filter materia�4� � - ��[- p � """-""""" Seepage Pit: Distance to nearest well - -------Distance from foundation"--."""..". ""-_.Distance to nearest lot line----------------- ❑ Number of pits71 ----- ----------.-Lining material--------------------- Size: Diameter--------------- Depth--- ----- ------ Cesspool: Distance from nearest well ------------. _Distance from foundation.-.."------____. Lining material_-------_."-------------- "" als. ❑ ' i Depth ---------------- ------Liquid Capacity- ----------- ------------•g Size: Diameter-:-- -------------- --- --- p - k Distance from nearest well------------------------ ------Distance from nearest building---.------------------------------------- Privy: , Distance to nearest lot line -__.__..._............. . -------- ----- r f' !/� i Remodeling and/or repairing (describe):------ - ----- ---------- ---- It r, j� ---- - - -- ------ --------------------- I,- --- -------------------- --------- -- 1 ____""._____-._."-.-_...-."..--_-__""_--"_"--""_F""_."-.-_""______________._._.________...___.------------------------------------ i ------- ------- `- - ------ ---- L 1-----------�---------------------------------------------------------'--------------'---'---"-----'---------------'----"------'----'-----------'-'---------'-'- I hereby certify that I have prepared this application and that the work will be done in accordance wi+h San Joaquin County f ordinances, State laws, and rules arid regulations of the San Joaquin Local Health District. F tc �•endfer Contractor) (Signed)_--�_#t� " _ _ --------(Title{----------------- - - --- ------ - ... ---- ------ - - BY: g p (Plot plan, showing size of lot, location of system in relation to Ils, buildin s, tc., can be laced on reverse side). 1 FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY--- ---- --- ------------------------------------- DATE---- --- --- -�------- - --�-�------- - DATE------------------------------------------------------------ L REVIEWED BY---------------------------------- ---------- ------------ DATE fBUILDING PERMIT ISSUED----------'-- ---------------------------------------------•----------------- Alterations and/or recommendations:"---------------------- - -------- ----------- ---- ----------- I ---------- -------------------------------•------------- .------ -------- ---- -- ------ --------- - ----•------ ------- ----------- ----------------------------- ------- -- ---- - FINAL INSPECTION ' SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazelton Ave. 300 west Oak Street 124 Sycamore Street 205 West 9th Street 5toekton,California Lodi, California Manteca,California Tracy,California E.N.9 2M 1.67 Vonguard Press