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- a .........t FOR SANITATION PERMIT Permit No. .1... .._...... lcate Date Issued ------- (Complete in Dupi 1°l►1 ` This permit Ex fres 1 Year From Date Issued " ®; U the San Joaquin Local Health District f� e permit to construct and install the work herein described. Application is hereby made to This application is made in compliance withCounty Or 6inan !:I Q ---------- JOB ADDRESS AND LOCA ION ---------------------------------------- Phone__.------------------------•------- �j d ------------- • -------- - ... Owners Name---- --------- -- ---------�•-- -----------------------------••-----•------------------------------•------------------------------- . ----•-- Address_ - t Trailer Court Motel ❑ Other ❑ Contractor's Name__-- T`� Commercial ❑ Apartment House ❑ jn4,4 /`S -----------•--•----•-------------•- Installation will serve: Residence ® I f-__�Number of baths __/___- Lot size --------- ----�-- Number of living units: ----L Number of bedrooms ` Private �] Depth to Water Table �~ - ft. Public system ❑ Community system ❑ Adobe (M Hardpan ❑ 4 Water Supply: Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ New Construction:�Yds K No ❑ FHA/VA: Yes ❑ N;o.?] ' Character of soil to a depth of 3 feet: Sand ❑ # Previous Application Made: Yes ❑ No'o[� ' TYPE OF INSTALLATION AND SPECIFICATIONS- TYPE sewer is available within^200 feet.) (No septic tank or cesspool permitted if.p n t }h Capacity----------------------- Septic frorrr nearest welly-; -------_-Distance from foundation------------------Material_ - Septic Tank: Size--------------------------------Liquid deP. i ❑ No. of compartments------------- Q each line-- --- ---='----------------.Width of trench �-� • Distance from nearest well______________ _-Distance from -----------------.--Distance to nearest lot line Field. (= ❑ Number of lines----------------------- Length o e ` Type of filter.rrnateriaL__"._.------ ----Depth of filter material-----------............Total length-- ----- --------=-------"---- ----------- ,.t �---.----Depth 1� Distance to nearest well___"- -- -------Distancep�founds zye nDiameter_-_y tante to nearest lot ine--"------- ---�-- t y \ Number of pits.-_---'___.__"-_----Lyning maternal____ -- 'k acit gals. Distance from nearest well----------------Depth et+hce from foundation_--=-----.-____liquid Capaning city Y--�----'--'-----"�"-"�-`-•- - --- Cesspool: -__---- p ❑ Size: Diameter-------------------- - ---------------- ----- F Distance from nearest building Distance from nearest we --_---"---- ----------------- ❑ ti Distance to nearest lot line------------------------------------------------------ ---------- -------------------------- Remodeling and/or repairing (d�E�scribe7--------------------------------- Y ------ LI ------------------------------------------------------ ------------------ ----------- done --------- ----------------------------------------- certify that i have prepared this application and oaauinhLocalkHealltheDistr cin accordance with San Joaquin County. I hereby Y ordinances, State laws, and rules and regula ' fof th a q - (Owner and/or Contractor --- ---- ----- Si ned (Title)---------0_oiE�1sr�4.�`"------------ - -------- (plot plan, showing size of lot, location of sys em in relation to wells, buildings, etc., can be place on reverse side. ' FOR DEPARTMENT USE ONLY DATE--------- r ------------------------------------------ ,f.r1 --- ---------------- APPLICATION ACCEPTED BY__"------------------- DATE____._.----------- -- ------ - --------- REVIEWEDBY------------------------------I- ---- ------ ---------•------------ ------------• DATE----�------�--"-------"----- --- - - BUILDING PERMIT ISSUED------r----•-----•----------- -------------------------------- ------- ------------------ ---------- Alterations and/or recommendations ---------------------------- --- ----------•----------------------- -------------- -------"-lL -------`= -------------------------------------------- -------- ------------- Date----- -` 't ----------- --- FINAL INSPECTION By----------------- SAN JOAQUINXOCAL HEALTH DISTRICT i32 Sycamore Street 814 North "C" Street 300 Wes+ oak Street Tracy, California i30 South American Street Lodi California Manteca, California Stock+on, California ES-9-2M Revlsed 8-'59 F.Q.Co.