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FOR OFFICE USE: --------------------------------------------------------- -------------------_ _--------------------------- APPLICATION FOR SANITATION PERMIT Permit No. ........ -- --- --------; Duplicate)------------------------------------------ (Complete in ' � Date issued .__'7`.... ...___.� ------------------ ------------------------------ This Permit Expires 1 Year From Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This-application-is-mad his application-is-mad n•-compliance with County Ordinance No. 549. JOB'ADDRESS AND LOCATION...Mc�_rt-hur---Rd-_-112-•mile___south of_-_Val Pico Road-r2rac77 .)-------- Owner's Name..-PAul..9en_-a_:....ChaS* Cunningham# Genl.__.�ont-r------------------ Phone-TTS -- Address__... Rt Mi Contractor's Name.The---DAY &_NIGHT BeFti_c_•Tank Service Phone........ 4__.£231___ Installation will serve: Residence:a Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: .....3. Number of bedrrrr Dumber of baths j-. Lot size ___3-j_-A.ares ---------------------- Water Supply: Public system ❑ Community system ❑ Private EX Depth to Water Table __35 ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel XX Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe 1!1* Hardpan ❑ Previous Application Made: (If yes,date___-_-- _---_-_) No ❑ New Construction: Yes MC No ❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION-AND-°SPECIFICATIONS: Ir!I (No septic tank or cesspool permitted if public sewer is availeble within 200 r jndation._fZeQet.) SApfic Tank: Distance from nearest well-----5-Q1----Distance f _ ________-Material...._. aci G 11____8- xxxNo. of compartments________ ________ -____Size_ lr; uid de th------ $.t------------Ca r Disposal Field: Distance from nearest well-_---5Q1----Distance from foundation_____ 0..__..,Distance to nearest lot ;n�... !........ Number of lines...._r�-......--------------------Length of each line_____ 0.-Width of french--------- . Type of filter mate rial.S_t?p�C_--Rtepth of filter material-----�.9-----------Total length__________ w ...___..._�� Seepage Pit; Distance to nearest 11well__j-QQt_-------Distance from foundation......50.._____.Dista ca to nearest lot line_____�_f_______ j Number of pits�`___L___.__---Lining material__RQ0&--------Size: Diameter `:7-.Depth. ..a Depth.___..-....-.IP-Q------------ __._ .-. - Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material_______-_-___________--_-------_-_-_-- �- ❑ Size: Diameter-------------------------- - Depth- Liquid-Gaacity-- -- gls` . s Privy: Distance from nearest well _____-_.-____________________________________Distance from nearest building.--_.____.___________________-__--______- ,.x Distanceto nearest lot line-------.=•------------•-----------------------•-------------........-------------------------------------------------._..__..._...-•-------- ,0 �: - ti Remodeling and/or repairing (describe):---------------- --------------- ---------------------------------------------------------------------------------------------------------------- ------------ Y. -----------•------•---------------------- -------•-------------------------------------------------•---••--------------•---------------------------------•--------------•------••-------------------------- - I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. (Signed)---The---]DAY... �`5epilis, � �r ContractorJ ._�..._ _�.-----_... :�. _ ,_ ... By:-•----•------------- ................................- ---------------------------- -- ----- •-- (Title)-------------------------------------------- ----------------- (Plot plan, showing size of lot, location of system in relation toldings, et ., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY------------------------------------------------- ------------ ,/ DATE----------- REVIEWED if' ---�---- ••----• - • r-• ->r - •-- •------------------ REVIEWED BY-------------------------------------------------------------------------- ------------- DATE -•- BUILDING PERMIT ISSUED--------------------------------------------------------------------------------- ------------------- DATE------------------------------------------------------------- ANterationsand/or recommendations---------------------------------------------------------------------------------------------------------------------------------------------------------------- ------- ----------------------------------•--••---•-----------•----------- ••-------------------------•-••-••---•---••--••-----------••------•---------------------•-•--••--•-•-••-•- ----------------------------------------------------------•--------------- ----- - —--- FINAL INSPECTION BY: ------ ----------- - •- Date /-0 --� - ---- ~ SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 124 Sycamore Street 205 Wast 91h Street Stockton,California Lodi,California Manteca,California Tracy,California ES 9 REVISED 6-59 YM 5-61 ATLAS