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Permit No. 5..-7. ... ,icy ry APPLICATION FO,. SANITATION PERMIT Date Issued A54 (Complete in Duplicate) 'A! is hereby made to the San JoaquinuL+caOrd�natnceDlNoG 549r a permit to construct and install the work herein described. This`'application is made in compliance with Co Y Phone Ho. _W .__. JOB ADDRESS AND LOCATION_. 2040---�,9,st___9�;h_; tQ __on� • ------------------------ Owner's Name------- ------- '� n Address. b .?.. -----------------------------•-----•- -`-----------------------•-------- Ho• 3-3955 Phone_ De1.-ta ` enc.----- - Contractor's Name______________________ _ Trailer Court ❑ Motel ❑ Other El Installation will serve: Residence ® Apartment House ❑. Commercial C] 1---- Lot size ._--- -'70 Number of living units: --_1- Number of bedrooms ----2__ Number of baths . , Communit s stem ❑ Private [I Depth-to Water Table 4-5--'- ft � . Water Supply: Public system ® Y Y ClayLoam ❑ Clay ❑ Adobe Hardpan ❑ Character of soil to a depth of 3 feet: Sand Gravel El Sandy Loam F-11 Previous Application Made: Yes ❑ No E� New Construction: Yes } No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: - " vailable within 200 feet.] (No septic tank or cesspool permitted if public sewer is a - X & 4x6-------Li Liquid depth-.-4.t---& --5.--..Capacity_-�u----- ------. r - cement brick z.ck ion Septic Tank: Distance from nearest wellrlQT1P---.--Distance from foundation--- 1-.---•-._ -.Material- ._-------------- ------- - P9 compartments of '10' _..__Distance to nearest lots ine.5 --------..- Disposal Field: Dist nce fromnea est welln`J ?�.-----Disfiance th of rom each line at40 ._._ _-__--__...Width of french 24 ------- -- Number of Imes --•--- --- -- Length es © Type of filter material_ ck__----_--___Depth of filter material_--;�- .------------Total length---.� �--Jr-- See a e Pi}: Distance to nearest we4!_none---_-----Distance from foundation--aIIlPle--Distance t-- nearest lot line----- ___------- Seepage ______ P 9 ® Number of pits- ------------------Lining material.--T'OCk-- --.._Size: Diameter_ ___. Depth--- .._._------•--------------- Distance from"nearest well_________________Distnce from foundation----- -_-.___.Lining material---------------------- Cesspool: _..Li..Liquid Capacity----------------------------gals. d Deth------------------------------------ ------ -- q P Y ❑ Size: Diameter--- -------------- ----- P -_---- .. from nearest building----------------------•------------•--- Privy: Distance from nearest well-_--------------- - .- -�,• - ❑ Distance to nearest lot line----------------------- y ` In"talin net - s-tem-�rplac-i.n o13Q--------•-------------------•-------- Remodeling and/or repairing (describe)------------- ------------------------ ------ ---------- ------------- \ I -------------------•---- -- \ ty ----- -- - ------ ' -------------------------•----••-------------------•----------------•----------------•- I hereby certify that I have andaregulationsdthis application the San Joaquin that the work ocal Healthwile done iaccordance wi#h San Joaquin oun ordinances, State laws, and rules Delta Iris (Owner and/or Contractor] 5i ned O"en-' Z"F ----- ---------------------------------------- By: • ---------------------------- PerryiJarthan- ---------------------------------- (Titlel------ -- BY (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY DATEV---------------•----- ------------------------------ -- APPLICATION ACCEPTED BY_�_-, -- DATE... __... -•-------------------------- PERMIT 15SUED-----------�- -� DATE c �! � -1 -=- -------i ---- "v----• l2--_57-._.._snnel ''� �.. ------------------------- BUILDING Alterations and/or recommendat�ons:__..�__.__._._.. ______________________ - -- --- ----------------------- I? FINAL INSPECTION BY:.- - - -- --- SAN JOAQUIN LOCAL HEALTH DISTRICT 132 Sycamore Street $14 North "C' Street 300 West Oat Street Tracy, California 130 South n, CaliforniaStreet Manteca, California Stockton, Califo Lalli, California ES-5 145445 ATWOOD