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-Septic Tank: <br />4.7 f,1 <br />" <br />,VDZPosal Field: <br />46,:?:;.*<;t: <br />' 'Seep4,71age <br />"tiity <br />' <br />Number of living units: / Number of bedrooms 3 Number of baths a- Lot size /0 ACRE:Si <br />ilater Supply: Public system Community system 0 Private E 'Depth to Water Table3S—ft. <br />erecter of soil to a depth of 3 feet: Sand 0 Gravel 0 Sandy Loam 0 Clay Loam 2--"Clay 0 Adobe 0 Hardpan ffi-L 11) <br />',PreviOus AT:splication Made: (If yes, date • A. - . <br />-.TYPE OF _INSTALLATION AND SPECIFICATIONS: <br />.4 (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br />Distance from nearest well 56DistanctaromAtundAve 10.,Material.C.4.Y.V<Ag:.17...... J5 <br />No. of compartments 2_ size„ ii x )0 x ST Liquid depth Y7z—.. Capacity lifiNam&P <br />Distance from nearest well 50 Distance from foundation ID .Distance to nearest lot line. Number of lines ,,,, Z.. Length of each line .76-4.4/5---,,, Width of trench zy " <br />A Type of filter material O C,-,14, .Depth of` filter material /7 Total length <br />it: Distance to nearest well /a or, Distance from foundation 10 . Distance to nearest kit <br />. Number of pits 2-- _Lining materibl. RO C.I‹ Size: Diameter.9A 7 .Depth / <br /> <br />Distance from fouddation Lining material <br />Size: Diameter Depth <br />;41 Distance from nearest well Distance from nea <br />.10-1 Distance to nearest lot line * <br />...... ......... 4 <br />b8eling and/or repairing (describe,- <br /> '111 <br />rest building <br />Cesspool: <br />Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br />This application is made in compliant with County Ordinance No. 549. es c Ler4 5- ri-y."- I <br />JOB ADDRESS AND LOCAT10 5)PE I no Ss j .E. R i /1200 <br />0 vrt e r's Milne I 1A1 - -- . r_ ....... I.4._LJ9Rp Phone <br />Address . 0 3)/12. RO5SIER RD EScil 4.4() <br />Contractor's Name_.4.1ALNEK Phone <br />l 4 i Installation will serve: I. tvs- Residence Apartment House 0 Commercial 0 Trailer Court El Motel 0 Other 0 * <br />I . <br />Distance from nearest well <br />No New Construction: Yes 0--"No 0 FHA/VA: Yes Er- No fi <br />Liquid Capacit gals y <br /> -roR <br />me . <br /> <br />I VP. UOC: <br /> <br /> <br />Z-7 <br /> <br /> <br />APPLICATION FOR SANITATION PERMIT Permit No. 21.7/r <br />(Complete in Duplicate) <br />Date Issued This Permit Expires 1 Year From Date Issued <br /> <br />t' <br /> <br />hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County C. <br />— 4 dinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br />- <br />.(Signed). 7G&12.--1,64 (Owner and/or Contractor) <br />By: <br />(Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br />FOR DEPIØTMENT USE ONLY <br />yt-B]J'ILDlNG PERMIT ISSUED DATE <br />"*PPLICATION ACCEPTED BY TI.R40- DATE .&Z - 67- . REVIEWED BY DATE <br />Alterations and/or recommendations:.._ -ii- Cai illoGEWG-s rr-- <br /> <br />FINAL". INSRECTI Date 7— /a- <br /> <br />SAN JOAQUIN LOCAL HEALTH DISTRICT <br />1601 E. Haxelton Ave. <br />Stockton, Califerisia <br />300 west Oak Street <br />Lodi, California <br />124 Sycamore Street <br />Manteca, Colifornla <br />205 West 9th Street <br />Tracy; California <br />' <br />• ,414:"..;4),;:_ •