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MIT D 9 Permit No APPLICATION FOR SANITATION PERDate Issued ----T'3 (Complete in Duplicate) o construct and install the work herein described. I.kJoaquin Local Health District for a permit t ad,, to the Sar:with county Ordinance No. 549. Ap Ication is hereby m --------- --------------- - cat-Lon is made in compliance; -- - ------------- -----�-- application 7— - 7 ------------ 7 Phone--- OB ------ -- DRESS AND L - -----*_0 joB AD --• - ------------------- --- ------------ -- ----------------- ---------------------- owner's Name----- 7 1 ------- ------------------------------------ ---------------- Phone__5�_,77y-- -----9------ -- Address-------------- - - --------- -------------I---------------------------------Trailer-I-er---------- -Court 0 Motel 0 Other 0 Contractor's Name----"------ commercial [] T yj dence Apartment House --------------------------------- Residence ---- Lot S"20 installation will serve* A— /,o t. 19 units- Number of bedrooms o --- Number of baths Water Table, Number of living N r'nb Privat6 0 Depth to W f Ad M - Clay 0 m_�/Co Community system 0 Clay.Loarn Adobe�ardpan 0 Water Supply; Public system Sandy Loam ❑ �epth of 3 feet: Sand E]. Gravel F1 Yes [] No Character of 501 +0 a _,/New Construction: ion Made. Yes I-A No [Re"� Previous Applicat . AND SPECIFICATIONS: Sfeet.) --------------------- TYPE OF INSTALLATIONpublic ewer is available within 200 feet k or cesspool POrm'tted -------------------------- (No septic tan. ----------Distance from 4oundation------------------ ----Capacity----------------------- septic Tank: Distance from nearest well-_----- Size--------------------------------Liquid depth--------- ------------ I . - to nearest lot line----------------- N�. of compartments-------------- ---------------Distance from foundation--------------------Distance Z ---- - width of trench-. ---------------------------- Disfanc6 from nearest well-,. each line--------- ------------------- I length------- ------------------------------'-- Disposal Field: --------Length of _ r lines----------------r---------- ------j--Total Number.l01 filter material--------- 5f lot Cl rial ----------Depth of Typeo"V filter matei ---------- ---- jou dation--___"--- to nearest -----Distance fro Depth------ ----------- ................ Size- Diameter 3__.to neares - ----- --"10-u Seep I------------Lining material I Lining material------------------------------------- -Nu'rnber of P"':------- foundation_-__-------------- -------gak. Distance from I Capacity-fj,orri.nearest well-- Depth----------------------------------- -- -------------Liquid Capac cesspool. - -- ------------------ building------------------------- F ---------------- S17'e. Diameter-------------------- ..-Distance' fr&n nearest building----I.,------------------- ❑ 9 Fj - ------- _:-----------------------_------- ---- ---- 'Privy: Distance hror'�n nearest Well-----------r----------------------- ---- 4, ------- ----------- ----------------------- earest lot line----------------------------------------------- Distance to n. -------------------------------I--------- ❑ 1- ----------------------------------- ------------- -------------I------------------ - Remodeling and/ repairing (clescribe)-_x--------------:------------------ ---------------------------------------------------------- ---------- ------r_ t-----I--------------------------I—-----------------------------------I - ---------------I---------- -------- --------------------------------------------------------- -------- -------------------- --- --------------------------------------------------------- _61unt ----------------------------------------- -----*---------------------------------- ------------------------------------------------ -------------- -------------- -------------------------I--------------- in accordance with San Joaquin ---------'-------- -be done --------------------------- prepared this; application and that the work will I hereby certify that I have Joaquin Local Health District. e ws, and rul'.i and regulations of the rSan jouipw and/or Contractor) ordinances, State -------------------------- ------------------------------------------------------------------ -- - - --------------------------- Si a-)" ► - ------- ffitle)---- - -- -- ---------------------------------------------- -----------------ca.n be placed on reverse sidej. gned--------------- .a ---- ---- ----- ------- buildings, etc., By -------- I to wells, buildi (Plot�plan, showi I ng.sille,of lot, location of system in relation RTMENT USE ONLY DATE--------- --------------- :77777777 DATE------ --------------------••-----•------------------------- APPLICATION ACCEPTED BY-----------------------=--- --------------------------- -------------------------------------------- -------------------- RFVIEWEDBy--__1__:1__1------- -------------- ------------------------------------- --------------I------------------------------- - DATE-.;---------------------------------------------------------------------- BUILDING PERMIT I ISS.UED----------------- ------------------------------------- - ------------------------------------------------------------------------------- ------------------------------ ---------------------- Alterations and/or recomrnendafions..___-_--- ------------------------------------------------_------.-. ----------------------I------------------------- t- - - ------------------------- - __:-------------- --------- ----------------------------- ------------------- ------------------r---------- --------------------------------- -------------------------I----i ------ -------------- ---------------- ............. ---------------------------- ----------_1-------------------------- --------------- ` i--------------------------------------------_-------------------------------- - ------------------ ----------:-------------------------- -------------- ------ ---------- ------------- ------------------- -- ------------------------- ------------------------------------------- ------ ---------------------------------------- Date..--------------- —S--------- ----------- FINAL INSPECTION By'------------------------- LOCAL HEALTH DISTRICT "C" Street SAN JOAQUIN 132 Sycamore Street 814 North 130 South American Street Tracy, California wesf Oak Street Manteca. California LodiCalifornia Stockton. California .. rr1_9" 2M 10-52 Revised W-21()()