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Date ft-2 7 6
<br />SAN JOAQUIN LOCAL HEALTH DISTRICT
<br />•
<br />.. .
<br />FINAL INSPECTION BY:. .... _
<br />APPLICATION FOR SANITkilON PERMIT Permit No.
<br />(Complete in Duplicate)
<br />This Permit Expires 1 Year From Date Issued
<br />FOR OFFICE USE:
<br />....... ....
<br />Date Issued
<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 compliance with County Ordinance No. 549. . 0..piitut/iiiies1,/ _ A7210#0,c,4 ei,./49.—
<br />JOB ADDRESS AND LOCATION. ..2‘. .../41:xgh2N..2ed,-: hi......e2f. War itiii,A1.2.5LAAP
<br />Owner's Name4-0kItet)..-41 - -----c-Par-e---i.V.11V-41:0-051 - Phoned7 3 .0
<br />Adclress*.e2. e... Wr,peR., - 7..:1742.0 14.4a's."7.t......4;"(.44._
<br />..2-f-
<br />_.,......,_
<br />Contractor's Nama_./.......2).,irf.:4-..N.4072.1a0750.s.:.._ ../.41r,z4i4.17/4'... , Phone _VZ .......
<br />Installation will serve: Residence 0 Apartment House 0 Commercial 0 Trailer Court 0 Motel 0 OtherW
<br />Number of living units: __ ..._ Number of bedrooms .. ... .,. Number of baths . , Lot size
<br />Water Supply: Public system 0 Community system 01 Private X_Depth to Water; Table ft
<br />Character of soil to a depth of 3 feet- Sand 0 Gravel D Sandy Loam Oct JClay Loam 0 Clay 0 Adobe 0 Hardpan 0
<br />Previous Application Made: (If yes, dcite I No 0 New ConstruCtion: Y;s 0 No 0 FHA/VA: Yes II] No 0 , 1 , TYPE OF INSTALLAllON AND SPECIFICATIONS: .1) -4,0 • i
<br />(No septic tank or cesspool permitted if public sewer is available within 200 feet.)
<br />Septic Tank: Distance from nearest wel1/119.`--Cristance from found)tion../."-- Mater.
<br />t4\
<br />No. of compartrnerits_ 7r.77 Size2#..74e.../ird'uid depth.. 1 ,,,,% 4'
<br />fs Capacity_.5.410. .. .._
<br />Dis$ii::.(s I Field: nc
<br />'
<br />Distae from nearest we
<br />.
<br />....._ Distance from founclaticm..../Cei_ ... Distance to nearest lot
<br />Type'o: filter matriae . . _ Depth of filter materal___ . Total length , , , f Seepage Pit: Distance to nearest:Cell ti. Distance from foundation.... ........... Distance to nearest lot
<br />EI Number of pits___ ______ ...... __ Lining maIterial • Size. Diameter Depth \I I -i Cesspool:ti Distance from nearest well _____ ....... _Distance from foundation... ___'.... ......Lining material 0 Size: Diameter
<br />Privy: I- ,.. Depth 1
<br />I
<br />1 Liquid Capacity gals
<br />••40 Distance from nearest well .. . ' Distarce fro;n nearest building-_-_---- ........ ___ ...
<br />Distance to nearest lot line • . CI .i.
<br />d - 'I
<br />Remodeling and/or repeiring.(ciescribe)- 1 ,
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<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 Sari JoaZiuin Local Health District.
<br />DAY & NIGHT • s, \ (Signed)._ 5 -'''s - -' Sepik _Tank .Servkw / t -
<br /> fOiseugziggiiiw Contractor)
<br />-.4:.:-. . •-' AO •— •
<br />FOR DEPARTMENT USE ONLY
<br />APPLICATION ACCEPTEDBY 4:*°4---- DATE ././.-`,4"-.6 REVIEWED BY DATE
<br />BUILDING PERMIT ISSUED DATE
<br />Alterations a dfor recommendations: i/26 7 Z4 19 -,seroz ''4!"-;4•0
<br />
<br />Number of lines .j
<br />Length of each line... Width of trench. 42,4feer
<br />Stockton, Conf.: •••••
<br />
<br />(Plot plan, showing size of lot, location ot system in relaf tor;ells, build' gs, etc., carilbe.placed on reverse side).
<br />...or a
<br />Title)_
<br />1601 E. Hauberk Aye.
<br />Stockton, California
<br />5,n, 9 2M 1-67 Vanguard Press
<br />300 West Oak Street
<br />Lodi, California
<br />124 Sycamore Street
<br />Manteca, California
<br />205 West 9th Street
<br />Tracy, Catifornia
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