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'PZ)R OFFICE USE; ------------------------------------------------------ -------------------------------- --------- APPLICATION FOR SANITATION PERMIT Permit No. -----------------7 --------------------- (Complete in,Duplicate) 3 Date Issued ---------------------------- ------------- This Permit Expires 1 Year From Date Issued Application is hereby made �p the San Joaquin Local Health Dist rict for a permit to construct and insfall the.work herein described. This application is made.in.c8mpliance with County Ordinance No. 549. 4�_A 7 o JOB ADDRESS AND LOCATIONLAN.--,-- -----It—QW- 4ATHRO D-------------------T,-Rq --- - ------------ Owner's Name----------W_.�---E__ oi-Al R------ .......C__.qh`on(`e:C_k--------j�ATHM. e' Addr ss....---------------5 ---------E Contractor's Name-------(9 -- --------------------- Phone----------------------------------- Installation will serve: Residence L] Apartment House Commercial Trailer Court L] Motel E] Other 1?"C_RL/RC_t+,r1 !FiNumber of living unit 11 i rooms s: ---- �ber of bed - ------ Number of baths -------- -Lot size -------- Com Wa+6'Supply: P�blicsystern Community sys rn E] Private E] . Depth to Water Table f 0 Character of soil to a depth iif-3 feet: Sand PGavel E] Sa�ndy,Loam Ll C,ay Loam L] lay.El lAdobe [3 Hardpan 0i Previous Application Made: (.If yes,clate--------- --------- No [V New Construction: Yes F� No E] FHA/VA: Yes Nolp�l TYPE OF INSTALLATION AND SPECIFICATIONS' 1� f .-- 1, -)It./ "_ 4p_septic tank errnitfitd if public sewer is.available wff hin 2Q0,fe0t 0�cesspqol.p S�F-DW-60> Septic Tank: Distance from neairest well---501 Di4anc. 4..�� nd.ii.n .... . 9F_ No. of compartments------- ...Aze- h i lCapacity.-_900 ------Liqui D Disposal Field: Distance from nearest well-5,0-----Distance from foundation---- istance to nearest lot lin Number 9f lines.-----!J--------�V-----------Length' of each line------/�_!----- ?.Width of trAnch-�0(60!-------------j------ of IT-1. - I Type of filter m a f e ri a -,Depth* jilter,m�jtqrial_r----24-------"Total length"I......#A�------------ ---------- .11 -0, fr - I . _ fj � I)Q Seepage Pit: D�sfance fo, nearesf,6ell-A,---- ------------Distance from foundation--------------------Di T "f lot line---------- ------ p I� .01; stance to neares El Num er 6:r _j b 'f_pits---------1----------1---Leming material-----------------------Size_: Diameter-------------I---------15JpfA------------------------------ or - I At 1 0 Cesspool: Disfanl_clllfi�'Irn near�esflw'e' ll----!-----A------Di,tance' from foundation-------------------Uning material---I -------------------------- h 0 A - 00 El Size: DiaAeter---------* ------------6epth------------------------- L-,q,ia Capacity_-------------------------gals, Privy: Distance from ne-.--. -------------------------- ------------------r.-_Disfarice 'from nearest building------- -:t -- -------------- --------------- 1- 1 11 . --------------- El Distance to nearest�lof line --------------------- ------------------------------------- ----------------0 Remodeling and/or re pEiliirin�cr,!(describe):--------- _PF__0.P1-- ------- -------I ---------------------------------- r -----------------Sp -------- _�05151ZTL_1 T K......AO_F��------a ------------------------t----- ----------------------------- ----------------------------W---------4ATf1p.,ap------- ------------------------------------------ ------------------ ------------------------------ ---------------------------------------------------I---------------------------------------------- ----- ------- ------------- ---------W--------- ----------- ---------- 1-111 � #L�, ----------------------------- ------------ her6l3y—ce;�;fi-fhat Phave pre�arled this application and that the work will be done in accor6rice 'with San Joaquin County ordinances, State' laws, and rules and, r�'e ula+io s of the San Joaquin Local Health District. - --------- --- (Signed) ----- --------------------------------------------------------------------------- -------(ler and/or Contractor) If 0 By:----------------------- t --------------------- ------------- =------------- ------------------------(Title)---------I --------------------------------------- --------- _...(PIof_pIan..,showingsiZe of lot, 6.aii.or6f 0 sySteM.1n_reIai�.on_+o_w ells, build in gs,-etc..-can cetf-ori.- reverse. FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY ----------------------------------------------------------------- DATE---------7_!r_-30 REVIEWEDBY------------------------4--------------- --------------------------------------1 --------------------------------------- DATE---_-----------kI BUILDI:NG,PERMIT-ISSUED4----—-------J------ �--;--------------------------------------- --------- ----------------------------------------------- ----------------------- AIfera:Fioni'a_nj/or recomm, e;4afi�ns:------ -------- ------------------------------------------------------- -----------!-------------------------- ------------------------------------------------- ---------------------------------- ------ ------ -------------------------------------------------------------_------------------------------------------------------ ---------------------------------I------------------------------------------_-- -------------------------------------------------------------------------------------------------------------------------------------- -------------------- ----------------------------------- --- -- ------------ --- ---------------------------------------------------------------------------------------------------- ---------- --------------------------------------- .. .... - ---------------- -- - -------------------------------------------- --------------- ------------ -------- ----------------------- FINAL INSPECT11 ---- --- -- ------ ------------- Da -------- ..... --------------------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Nexelton Ave. 300 West Oak Street 124 Sycamore Street 265 West 91h Street Stockton,California Locli,California Manteca,California Tracy,California ES 9 REVISED B-59 :am 3-'63 F,F�1213.