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.v ,., <br />APPLICATION . FOR SANITATION PERMIT <br />(Complete in Duplicate) <br />This Permit Expires 1 Year From Date Issued <br />Permit No. .g.e.A.1._.7 <br />Date Issued " <br />Owner's Name ci:74‘14-A•fe"'' '-'2274( .94') Phone <br />Address ,C?.:3.4:/ <br />Contractor's Name lie-44 —ziC .J Phone <br />Installation will serve: Residence P4"Apartment House 12 Commercial El Trailer Court 0 Motel 0 Other 0 <br />Number of living units: / Number of bedrooms . Number of baths 02.- Lot size I <br />Water Supply: Public system 0 Community system elrivate 0 Depth to Water Table .alt. <br />Character of soil to a depth of 3 feet: Sand 0 Gravel 0 Sandy Loam 0 ' Clay Loam 0 Clay 0 Adobe mHardpan 0 <br />Previous Application Made: (If yes, date ) No Fie"" New Construction: Yes ErNo 0 FHA/VA: Yes EZ.--- No D <br />TYPE OF INSTALLATION AND SPECIFICATIONS: „.....-4 <br />(No septic tank or cesspool permitted if public sewer is available within 200 feet.) , <br />Septic Tank: Distance from nearest w. ./- /Dist'anc9- frop founclatir eV Mateiial e <br />No. of compartments.'04 <br />ie—ooPiettr5-7:: <br />Size.,Xt‘ .str ..ei(Liquid depth 1'• -Ca pacity/72 3 <br />; <br />4*1 <br />e ,,,e7 <br />Disposal Field: Distance from nearest wel1/4 <br />,..„,„ <br />.a.. Distance from foundation 0-Jr.' Distance to nearest lot line._c?.... ........ <br />Number of lines_ .2 ,....... Length of each line., ' Width of trench...2 1 I , <br />Type-of filter material/OA" ele.- Depth of filter material...o/d"?' Total length. ,,,e,effe 'e ) <br />LI Distance to nearest lot line <br />Remodeling and/of i'epairing (describe)• l'71•144.1 .• <br /> <br />..,..,,, <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 N . 549. ..„. lqi4A--) s• 070 ---/00 — a . g-cie44,04,/ .oet. .7/9 <br />jr. JOB ADDRESS AND LOC/VflON."4 / If__ eg..14/....4.0.... <br />e—• <br />Seepage ite:SYn* Distgice to nearest well .e 0-- Distance fr,-,9m foindation Di,stasice to nearest lot line, <br />Number Of pits__ Lining material .#.49‘,00 Size: Diameter ilie.e0Xei Depth 4411"e <br />Cesspool: Distance from nearest well' Distance from foundation Lining material <br />Size: Diameter Depth Liquid Capacity gals. <br />Privy: Distance from nearest well Distance from nearest building <br />/ `Woo, <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 /> fecimmailkWor Contractor) <br />(Title)./.2.— <br />(Plot plan, showing size of lot, location of sys in relation to wells, buildings, etc., can be placed on reverse side). <br />(Signed) <br /> <br />By: <br />FOR DEPARTMENT USE ONLY <br />APPLICATION ACCEPTED BY. s•---. kiaL • DATE d 13161. <br />REVIEWED BY DATE <br />BUILDING PERMIT ISSUED !WE ' <br />Alter ions and/or reco endations: <br />...A.)..a.:.... <br /> ..e..,....- <br />FINAL INSPECTION BY Date //76' <br />SAN JOAQUIN LOCAL•HEALTH DISTRICT <br />1601 E. Ilazelten Ave. <br />Stockton, California <br />., 300 West Oak Street <br />Lodi, California <br />124 Sycamore Street <br />Manteca, California <br />205 West 9th Street <br />Tracy, California <br />F.P.CCI.