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APPLICATION FOR SANITATION PE 3 RMIT Permit No. -��"-- (Comple+e in Duplicate) _ Date Issued --�__�-. Application is hereby made to the San'Joaquin Local Health District Th is.apppplication ism de in com liance.with Count Ordinance No. 549. a permit to construct and install the work herein described. f �Y. •J(�>� A$-Vic— Y On cast side off' Redwood Road JOB ADDRESS Aft LOCATION_4adwood. Rd Just north of 2nd. St. French Cam _ - - --- ---- - ------------- ----- -- - Owner's Name-------------------------------" "-"--Ci ( G Pettin Investment Co. P r ---- ---------- -- HO b8�15 122E Church 6t, for Re --------- --- Phone--- --- Address ----------------------------- -- YnOld:--} - --------- t Contractor's Name____DAY" &- NIGHT Se t1C Tank Service •'-----------------------•--- p - ----------------------------- Installation will serve: Residence ---""""""" - --------- Phone.."""q""�70�i - ----------------- " --------------•- Apartment House E7 Commercial E] Trailer Court ❑ ;Motel � Other ❑ Number of living units: _1_-_- Numer of bedrooms __-2'•-" " " bNumber of baths _a.-___ Lot size Water Supply: Publics stem Y ❑ Community system ❑ Private A Depth to Water Table -------- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sand Loam Previous Application Made: Yes No Y �► Clay Loam ❑ Clay ❑ Adobe ❑ Hardpan ❑ ❑ [X. New Construction: Yes E] No)M FHA/VA: Yes No TYPE OF INSTALLATION AND SPECIFICATIONS: ❑ ❑ HousC to b6 -; (No septic tank or'cesspoo! permitted if public sewer is available within 200 feet.) moved in Septic Tank: Distance from nearest 2e11_ Q.� Dist r}r_eXfrojryfondtion7.0;" ""__".- Mt�rial- ""CC" BrC°k No. of com artments---___ 50 -"-_" Siz __ 6%x -- - -6--- -- 3 3----Liquid depth--- -----------------Ca Capacity__-__0___0__ __G__a__Z_ S Disposal Field: Distance from neares well--59. Distance from foundation20.E � p Y VC Number of lines___ _____________ Length of each line----6Q-� ------Distance to nearest lot line.-f_,"""___ Type of filter material SCP.--_Rk_ Width of french,-Z4" Depth of filter material_ 18 --'"""--- Seepage Pit: Distance;to nearest well ""_"" Total length___._-120----------------- N -----_---- Distance�from foundation___________________.Distance to nearest lot line_-___..__-_______ ❑ Number of Pits--------------_"---""Lining material___---___-_ = -----------------------Size: Diameter------------------------Depth_------------------------------ El ----------- ------- - Cesspool: Distance from nearest well----------------- "-"" Distance from foundation_._._-_-_--- ----.Lining material----------------------------------� ~f ❑ Size: Diameter--------------------------- ------- ---Depth-----------.................. Liquid Capacity----•---------•-------- -- alr , Privy: Distance.from nearest well _"-__",__-""___-:-"- ". Distance from nearest building---------------------- - ❑ Distance-to nearest lot line------- __- -- o ---------------------- ------------------- rep - ---j----- -- Remodeling and/or repairing (describe):_____..-__"--""__ ""-. ----- -------------- ------•-------- ---•------- -------------- ------------------------------------=----------- f r --- ------ ----------- a,.. l -- j ----------------------------- f 4 - ---------------------------------- r:T�"... ` �— ----'----------------- ._ I hereby certify�tha+ I have prepared this application and that.+he,work will be done in accordance with San Joaquin Countj ----------------------- -- --- - - ------------------------ - ordinances, State laws, and rules-and regulations of the San Joaqui Local Health District, j (Signed)----•DAY-- --- & NIG* ;SeptiC Tank Service _ - -- -------------------- ---------------------------------------------------- BY=-----------•------` ... k - - (�r Contractor - --- - --------------- (Plot plan, showing size of lot, location of system in relation t ells, buildings, r (Title) can be placed on reverse side), I FOR DEPA MENt USE ONLY APPLICATION ACCEPTED BY ------------ _____ DATE REVIEWED BYf -----------_ �.%P/ DATE----"- "` c ______ � BUILDING PERMIT ISSUED--------------------------- = = = - DATE- ' Altera+ions and/or recommendations__________________ -- - - - - ------------------- - - ---------------------- - -- ------- ---------------- __ _. "-_.__----------- --�- --- --- - ------U' - t p -------------- j ------- FINAL INSPECTION 'BY:.__-_.---_""._-."__-•--- - -------- -----•---- ate------- ------- - -- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2M , Revised 1-57 F.P,CO.