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FOR SANITATION PERMIT Permit No. _47_."��T APPLICATION (� (Complete in Duplicate) Date Issued Zfn(�zw—off A kation is hereby made to the San Joaquin LocaThis 4 Health District for a permit to construct and install the work herein described. application is.made in compliance with County Ordinance No. 549. pP _f.- . , ----- ---- - ; J013 ADDRESS)AND OCA N ane--- ------------- Owner s Name:___"-- •"-- �yl -- -- --------- }-------------------.---------------•------•------- Address------ Phone ---------------------------------- Contractor's Name n ', Commercial Trailer Court ❑ Motel ❑ Other ❑ Installation will!serve: Residence EO Apartment House ❑ ❑ _ , 1" --- Lot size ----�•-�---- - ---• --�- --------------------- Numberiof living units: ---I---- Number of bedrooms ._A„-- Number of baths __�" Community system ❑ Private ® Depth to Water Table .9-0 ft. Water Supply:'! Public system ❑ Y Y Clay Adobe E] Hardpan ❑ Character of soil to a depth of 3 feet: Sand Gravel [I Sandy Loam C1 Clay Lorin ❑ y ❑ Previous Applicafion Made: Yes ❑ No New Construction: Yes A No El TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) I 0 e from founton---- . _r_ __.""". _ OCa Capacity Tank: Distance from nearest well___7-0-------Distanic --Liquid depth----4- No. of compartments--------- A from foundation__f -_-----__.Distance to nearest lot lined�__-_'- ______- -� Disposal Field: Distance from nearest well--- _ "__--- -Len Length of each line--- ------Width of french-------��................ .--� ® f Number of lines_------- ------------ 9 r' Total length �1--J � Type of filter material-- of filter material_____ --:---- 9 { -Distance from foundation___________________.Distance to nearest lot line__.___.____ Seepage Pit: . Distance to nearest well________- _-----De ❑ Number of pits------ ------ -------Lining material----------------------- Size: Diameter----------- y_ Dept _ , _Cesspool: Disfiance=from nearest-we4l___3___--_:_:='Distance from foundation____________________Lining material___"_____.-____.___-__..__ __._-.- ------------------- ----Li Liquid Capacity----------------------------- ----------------- --------gals ❑ i! Size: Diameter------------------------------ -------Depth----------------------- q x - ------------ - --------Distance from nearest building--- ------------------------------------- r-•C, Privy: Distance from nearest well_____________________ __ Distance to nearest lot line________._________. -- ----•-------------------- - i ------------------------- Remodeling and/or repairing (describe):_____-- ----------------"--_-- ---------------- ----- - --••----------------------------- !1 - ------- --- ----- ------- 1 hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. _______________(Owner and/or Contractor 'L - 1�--- --- ------ (Signed) a . Y� z t I Tale Plot plan. show, g - z lot, to ---• -- C ( P owl g size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FO A TMENT USE NLY DATE------- - - -- APPLICATION ACCEPTED BY____ _._- ------ REVIEWEDBY--------------------------------------------- ----------------------------------------------------------- BUILDING BY ISSUED---------------------------- --- ---------------------- DATE Alterations and/or recommendations--------------------------------"----_.._-..__----------- --------------- ---- -------------- ------------------------------------------------------- II --------------------------------------- 1 - ----- ---------------------- - FINAL INSPECTION BY______________ ___ __ _ _ ...... Date - --- ------- SAN JOAQUIN LOCAL HEALTH DISTRICT 3DO Wes+ Oak Street 132 Sycamore Street 814 North "C" Street f30 South American Street Lodi, California Manteca, California Tracy, California Stockton, California ES-9-2M 10-52 Revised W=2100