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Permit No. <br /> APPLICATION FOR SANITATION PERMIT <br /> (complete in Duplicate) Date issued <br /> Applica4-ion is hereby made to the San- <br /> Joaquin Local Healtnance h DisfNo.rict for a permit to construct and install the work herein described. <br /> Ordi549. <br /> This application is made in compliant with CountY <br /> ------ --------- -------- --------------------------------------------(-f---------------------------- <br /> JOB ADDRESS AND LQQATION------ --- ------ -_&------<-------- ALO A-9-71(------- <br /> Phone-------------- -- <br /> 6i T- <br /> Owner's Name.---------- e-1- ­ - � <br /> ----------- ­---------I---------------- <br /> DA NIGHT ---------------------------------------- ----------------------- <br /> Address----_------------------- -Septic---- ­UA-Service _417 C,qP----------- <br /> Phon --------- <br /> 11,10-24-9*------------- ----------------------- <br /> Contractor's Name_-______..__ --- on Court,[] Mote, 0 iOther e4v: <br /> tFMf. Commercial El Trailer <br /> . C <br /> Apartment Installation will serve: Reside 0 4 Apa' me"n ----------------- <br /> .6 rooms -------- Number of baths ------- Lot size <br /> Number of living units. N bei of bed <br /> ommunity system [I Private F1 Depth to Water Table ft. <br /> Water Supply: Public system �_ C 0 <br /> I Gravel 0' Sandy El Clay 0 Adobe J;--+-tgrdpan El <br /> Character of soil to a depth of 3 feet: Sand F1 Clay Loam <br /> Ye <br /> Previous Application Mad'e:'Yes' New Construction. �10 <br /> E L <br /> LLATION AND <br /> TYPE OF lNifA SPECIFICATIONS:' available within 20 feet.) <br /> septic tank or cesspool permitted if public sewer,is <br /> • (No sepr 0 ----- ria------ ----- ----- -- <br /> -fl3istance frov ati - - <br /> ----- Materia <br /> D nearest well �04 JA_ , . <br /> Septic Tank: Liquid clepth-----�70 :�apajt --- ------- <br /> !stance from nearest well ------ ( I <br /> No. of compartments-------- ----------- ----Size -t ----------------- <br /> Disposal Field: Distance from nearest well------------ ...Distance tance to nearest lot ' <br /> Number of lines------------------ ---------:------Length of each line-------------------.---------.W dth of french----------------------------------- <br /> N -- ----Total length------------------------------------------- <br /> -Type-of filter material__.--_._------------- of filfer.material <br /> e to nearest lot line- <br /> - ----------Dis <br /> from founda'fion__�, fanc <br /> Distance r 4e. .....Distance <br /> Seepage Pit: Diste to nearest wel*n ........Depth_-_-!DV. --j--------- <br /> Number of pits-t_-----/------------Lining material Diameter <br /> from-nearest�well._:_%=----------Distance from foundation:--- --------------Lining materia <br /> Cesspool: Distance f, -------- -------Liquid Caaa city----------------- <br /> -E] size.-_�,-Diam eter-------------------------I,.----,-_Depik------------------------ ------------------------------- <br /> Privy: Distance from nearest well--------------------------------------- ------- <br /> --Distance from nearest building___________------------ --------------- <br /> Distance to nearest lot lOne-_.-__-.----------------- ----------------------- <br /> El ----------------------------------------- <br /> I - <br /> ......00 ........::�-44,4v?z- - <br /> ------6------------- <br /> Remodeling and/or repairing (clescribe):_---------------- -—----- --------le ----------------------------------------------------------- <br /> -------------- <br /> ------------------------------------ --- <br /> - ---------- - --------------­- <br /> ----------- ------------------I-------------I-------------------------------------------------------------I---------------------- <br /> le - --------- - *­-----------I--------- <br /> ------------------------------ -------- ------------------------------------ <br /> ------------------------------------------------------------------------------ <br /> ----------------------- Joaquin County <br /> - ------- --- --- - ----- <br /> ---------I-_hereby-_certify iha-t-_I-_have prepared this application and that the work will bdone in accordance with San <br /> ordinances, Sta and rules B*f vf�3�01 the San Joaquin Local Healtheli str <br /> Tank Serviai ------- -------------- (Owner and/or Contractor) <br /> rl <br /> -0dorador-410WAF00- ------ ------ ------- ATJ ------ ---- -------- <br /> (Signed)-----------ja-----1-2061oplic -7 fie)---L( _-_X1 <br /> --------------- <br /> By:------_-----%�------------------------- <br /> Stockton, Calif. etc., can be placed on reverse side). <br /> (Plot plan, showing size of lot, location of system in relation to w wells.. uiliding.s, e <br /> i FOR DEPARTMENT USE ONLY <br /> ------------ - ---- DATE_ � -------------------------------------------------------------------------------- <br /> APPLICATION ACCEPTED -- ---- -------- <br /> --- --- ----- ----------------- - DATE- - <br /> REVIEWED BY------------------------- ---- -------------_ DATE-----:��------------------------------- <br /> ----------------- <br /> ----------------------- <br /> --- <br /> ------------- <br /> BUILDING PERMIT ISSUED------- ------------------------------w----- ------- 7 <br /> - I -------------------------------- ------ n-- <br /> Alterations and/or recommendations*------- - <br /> ------------------ <br /> ^ - -------------_-------------------------- <br /> - -- -------- --- ---- <br /> --- --- -------­------ - --- <br /> - ------ ---- <br /> . .... ----- <br /> ---- -- -------------- <br /> ----- --- ------ ---Aj <br /> ------------- <br /> Date_----------- -------- ----- ---------------- <br /> FINAL INSPIEM-CTI"ONB ------------------ ------------ ------------------- ----------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 300 West Oak Street 132 Sycamore Street 814 North "C" SIF60t <br /> 130 South American Street Manteca, California Tracy, California <br /> Stockton, California Lodi, California <br /> Ems-3-2m 145846 ATWod� 1 -54 <br />