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LA S / APPLICATION "FOR SANITATION,.I'ERMITA P rmit No. ._i I (Complete in Duplicate) .53 1 a+e Issued L ---_..__�.__. �Applicafiion is hereby made to the'San Joaquin Local Heal#Ii,Dist�ict,for a permit to b Of t-a "�taJl the work herein described. This application ismadein compliance with County Ording'nti No.`549. i Vll JOB ADDRESS A LOCATION--- - - --------------------------------------------------- Owner's f1Name_ K 1__ - 1 _ __ Phone__2___�� ---- Address trr // -. -_.^.�� - ----------------------- --------- Contractor's Name______________________ � ommercial ,.� Trailer Cou�_t�..-. ..:.Motu one..- Installation will serve: Residence Apartmen Ouse ❑ C ❑ ❑ I ❑ Other ❑ -� Number of living units11//_____ Number of bedroo�s�_ Number of baths .Z2__ Lot size _____- _ - ------------- -[� Water Supply: Public systemk Community system ❑ Private ❑ Depth to Water Tabl5,j_;&"'ft. Character of soil to a depth of 3 feet: Sand ® Gra 'el ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ' Hardpan ❑ r6 Previous Application Made: Yes ❑ ANo� New Construction: Yes No ❑ � � r TYPE OF INSTALLATION AND SPECIFICATIONS: �� ►► �} (No septic tank or ceskool permitted if public sewer is available within 200 feet.) ! " piHs ------------------------ ----- -------------- .- Septic Tank: Distance from nearest well__ Distance from foundation_-__ -------------- t • ' � Matenal____� ._ No. of c}mpar+men}s--------- -------------- Size.. ; ' .--Liquid depth Capacity �J�� Disposal Field: Distance from nearest well____.._.-___�_Distance from,foundation__________ _________Distant to nearest lot line______________.._ ❑ Number 'J lines--------------I-- ------- � Length` of each':line----------------- -1 W�dtli�f trench. Type or filter material------_ --------_---__Depth of-filter material------------- .__. Total 41, 4 ------------------------_A________-_ II P - . Seepage Pit: Distance to nearest well, ttT._[Distance from found'at+on_A �_..____.Dist�nce to�earest lot line---r (� Number of pits___.__-_______Lining imaterial_, -size: Diamete t___ _ -._____-.depth_____.__� ____----------- X _______-_ /� -- F ]. I ,. Cesspool:. ;,...�Disfance 'from3nearest welll�__Distance from foundation--------- - ----Lining mate ial__.-.'x_____--------.-----I__-__-___ Size: Diameter}-___-______ _ �._-__._De th_..-----_--------------------------------- ___ Li uid Ca eat els. Privy: Distance from lnear--. we __-_____________________-----_Distance fro nearest building____-_-_____-_-_____________----__---_. ❑ Distance to nearest lot line--- ------ i Remodeling and/or re airing (descr• e)---- ---- - -------- - --------------,----- --- �-_.? ------------------------------------------------------ i h- , - ------------ - - - ---------------- - = - ---------------- -------- -- - -------------------—----- Y prepared -------------- --------------` = ---------------------- E r 4 T+ # k t K i t I hereby certify that I have re ared this application and that the work will be done in;accordance with San Joaquin County ordinances, State laws, and rules and regulations of the-Sq an"J-o uiu Lot 661-Health Dis+Act. r A _l._ . Si ned --- ----------------- ------------------------------ Owner and or Contractor ( 9 B • - ' J '� ------rthe -�T" t ---------- y. I l r = ---- _ = (Plot plan, showing size of to ,notation of iyrstem in relation to wells, buildings, etc., can be�placed on reverse sidd). ' FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-------!y- - ------ DATE ------------------------ -------------- -------= REVIEWED BY----- - ----------------- DATE ------1e BUILDING PERMIT ISSUED___--____-- -:___-- t -- DATE--- :----------_ts-- ----- -= Alterations and/or recommendations t�--�--- l________-�•_ 1 =__.....-•-- •-------------------•-----•-•-------_--• ,� � � f _ - - - - - -- 1 Il -------•-------------------------------------------: -- ----- ---------- ------------------------•-------------------------------------------------- tr -- ------------------------------------------------------------------------------------ -- ---------------------------------------------------------------------------------------------------- = I ------------- `' - FINAL INSPECTION BY------------ ------------- `- " y: Date------------- ` --------------------••-- ♦♦ SAN JOAQUIN LOCAL HEALTH DISTRICT ,a 130 South American Street I300.West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-4-2M to-52 Revised W-2100