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Fq)R OFFICE USE: <br />------------ ----------------------------------------- APPLICATION` FOR SANITATION PERMIT Permit No. <br />..............t7 <br />---------- - ---------------- --------w7------------- (Complete in Duplicate) Date Issued <br /> ---------------- --------I------ This Permit Expires I Year From Date Issued <br /> Application is hereby made t; the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This app qafiq9js-rDade in compliance with County Ordinance No. 549. <br /> thrb <br /> - <br /> JOB ADDRESS AND Lt, -o-f uetin d,­-K,�a� <br /> CATIONS&Q..­Sidpe---Qf 1-a -p--R&---300'---V� --A ------------------------- <br /> Owner's Name-Guars nt-ae-d--Romas... oymer--j.,vjjjjam­sgg-e-rz---Bj--14Q--------------------------------------- Phone--I----------------I------------------- <br /> Address---------------535 So. San jo --- ----------------------•-:_:-------------•------------. <br /> ------------------ ---------------------------------------­-------------------------­-- ------------------- <br /> -- ---------- <br /> Contractor's Name-!%P-l-s---SP-9UC---SeZvame.. --­-------------------- -------------------------------------------------------i------------- Phone. <br /> Installation will serve: -Residence [Z Apartment House El Commercial E] Trailer Court 0 Motel E] Other F1 <br /> Number of living units: --I--- Number of bedrooms ___-4- Number of baths ---2--.Lot size .1 1 QQ I Q-1 XW -------------------------------------- <br /> % ' I <br /> Wafer Supply- Public-system El Community system D Private ® ,Depth to Water Table ft. k <br /> Character of soil to a depth of 3 feet: Sandf] ' Gravel []- Sandy Loam Lj ' Clay Loam []0-Clay El Adobe E] Hardpan C] <br /> no tion: Yes :91 No Ej FHA/VA: Yes F <br /> Previous Application Made: (if yes,clate-­- ..------ ---) No f-1 New Construction: No [2 <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is-available within-200 feet.)-4- <br /> Septic Tank: Distance-from nearest well---5Q----------Distance from foundation---10!-----4------Material -------------- <br /> No. o�1,cbmparfments----' 2. <br /> --------------- - ---Size--W, 9-------------------Liquid,dep.th---W-.-­------ ------Capacity-.1200---ga-1. <br /> Disposal Field: Distance from nearest w 11_.__50_'____-.Di lance from founda t,o 111 _"._.Distance to nearest lot line--0-5-1------ ­Z <br /> 119 Numbef of lines�-4 ------ tIgef french---21-=Z- -­1 ----- — <br /> - /�6--- <br /> Type,,of filter maferiaI-­.:--iPk............De th of length---Q(��-­ <br /> ro p jilter mater al <br /> Seepage Pit: Distance to nearest well----------------------Distance from foundation--------------------Distance to nearest lot line_- "-_-_: � y .._ <br /> E] <br /> ine----------- <br /> El Number of pits----------------------Lining material----------.--------_--.Size: Diameter---------------------- Depth------- --------------------- <br /> Cesspool: Distance from nearest well---------_-"".'Distance from foundation--------------------Lining material_---..."-_-.----- _--_-___---- � Y <br /> I <br /> ❑ Size: <br /> aterial----- -------------------------------- <br /> Size: Diameter------ ----------------------I------lDepfh------------------------------ -------------------t-Liquid Capacity-..-.-----------------------gals. <br /> Privy: Distance from nearest well-------------------------------- ----------------Distance from nearest building-'---------------------------------------- <br /> 0 Distance to nearest ]of line--- -------------------------------- -- ---------------------------------------------- ------------------------------------------------------ <br /> Re and/or re airing (describe): Y-F-RX,-----�9A- -1150-14,­—------- ------//V------4" ------- <br /> -4 P�LA t <br /> ------- \J.E-R 19&F.-.: --------------- -------�-Vb------------ ---------------------cer�­ <br /> -Y ----------- ------ <br /> Rsoor ri 01,J --------I- --------nF-------m8r-1�4-C-4--------vs------ --- ------------------------------------ <br /> ----------------------- A <br /> -------�400 ------------------------------- ---------- ------ <br /> -- -- ------------------ ----------------- -- <br /> - <br /> I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> ---------------------------- --------------------(Owner and/or Contractor) <br /> (Sign eci)-----Tke-'--a Ir- ce------ - ------- --------------------------------------- <br /> 0 <br /> By:------------ ---- -- -------- 11---- ----- --------------(rifle)------------v-------------------- ----------- ------------ -­ <br /> ---------------------- <br /> (Plot plam.,showing size-of-lot.-locat on-of sysfem.,in relation-.to-wells;buildings, efc., can+be:plac-6d­on-reve�se-si&). <br /> Seat a*m* <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY--------- --------------------- L00 <br /> DATE-------------- --- ------ --�/------------------- <br /> V Y DATE------------ ------ - <br /> ------------------------------------- <br /> REVIEWED BY---------------I--------------------------- ------ ------ ---- -------- T <br /> _ L - ----- - ------------- - ------- --------------- PA E--------- - ------------------ - <br /> F:��Ar � ��6 �-------------- ----- --------- ---. . 7 , �� <br /> BUILDING PERMIT ISSUED -------------------- -----------------------------------I--------------------------- DATE-------------------------------------------------------------- <br /> ------------ <br /> ---------- 4 <br /> Alterations and/or recommendations .....VVE�A-n�L­ <br /> IN-0 --------- ---I-V-S--------------------- <br /> ------- ---,m,.---- =----------------------------------- ----------------------------------- <br /> ----------------------­----- t 1 11 If ILJr ------------------------------------- . <br /> ---------------------------------------------------- ----------------- --- -- ---------------------------------- <br /> 1. ------------------------- -------- -------------------- ---------------- -------------------------------------------- ------------------------------- -- <br /> --------------------I-------------------- ------- --------------------------------------------------------------------------------------------------------------- <br /> -- ---- ----- <br /> ----------------------- ------------------- ----- - -------------------­ .....611072 <br /> ---------- -------- --- DaW­'2�.,W-----7 -------- --------------- <br /> FINAL INSPECTI Y------ <br /> SAN. .JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 91h Street <br /> ofni --- California-Cdlifornia Manteca,California Tracy',California <br /> Stockton,Cirif' a <br /> ES 9 REVISED 93-59 3M 3`63 F-F,100- <br />