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OFFICE�USE- a �1_._..----• ----,"---- . SANITATION PERMIT Permit No. -•- - 7�oR --------- ---- - APPL1CATlCJN FOR is� C Date - _ ------- --------- (;Complete in Duplicate) - `This Permit Ex fires 1 Year From Date Issue a ______________ ermit to construct and install the work herein desced. ----------- a No �l��/ (J�i' Application is hereby made to the Son 'J th'Joaquin Loce Health Distric549 t or a p T/ This application is made in comp• C � -- -_- -- -------, � s -� 1 _N .:: 1Q --- ---- -------�---- -------� Phone_._...------•--- -------•----------- JOB ADDRESS AND LOC ON------ -------- ' ----------- . Owner's Name----------- - v 11_i?---------- -� TQC -- -------•-------------- IIIlIsL54/ _, - f�- ,`'� == Phone:--------------------------------- Address------------------ •Address-------- ---•---•----- -- ------------------------------------------------------------------ ---- - Motel ❑ Other Contractor's Name__.f�I �. -------------------------------------------------- or f❑ Trailer Court ❑ ��S A artment House ❑ o} size ""- x----_2— r installation will serve: Residence p Number of baths Number of living units: J--- Number of-bedrooms -_-7- th,�ta Water Table-=---- ft• Community system ❑ Priva�:.` p� 1 Gla Adobe❑ Hardpan ❑ k Water Supply Public system [] T Cla Loam 0 y ❑ �N0 ❑ l Gravel QT'tSandy`> am Y FHA, Yes I Character of soil to a depth of3 feet: Sande a,o - _. - �/�lew Cons#ruction: Yeses. Previous Application Made: �4f yes,date_..--.--- N Y. rr5. -, '" .—. TYPE'OFTINSTAL1:ATlON�AND SPECIFICATIONS: C �---------- i (No septic tank or cesspool permitted if public sewer is ailabie within 2d / ..,.. Mat ria �'D/V R. �5 Z_3 k'') Li u'd depth-- �':-. capacity------ ------------- f 5� Distance frm nearest-well- - `""�ti ea �}'9un a i q- - �1 I Septic Tank: - -- -- Distance fio nearest 10# in�� No. of compartments___: f on {o nda ion_ -- i Distance from neares# well__ - a�i on }n tr -idth of french - Disposal Field: ength o each fineoQ----------- �f ,Number of lines------ ofl length Type or filter materia}'' OC14�- " Depth of filter material---- --- - is.!ance to nearest lot line._. - Depth ----------- Seepage Pit: Distance t i est well. Lining material from founds ze n piameter._ _-------- - - I ❑ '�Z�Number of pits--- r �..... ii in maferiaL. ------------------------------ - ' p t ance t in oundation ' k g t — { '. g 4s Distance from nearest well_ Liquid Cap u Y a } " Cesspool: �- Size: Diameter------------ ------- .Size: > Distance from neaestbuilding- _ _. ❑ I >4 . t ------ --- ,.- ----- k "_ ��Distance from nearest we ---------- --- --- ---- •---"--"-- ----- Privy: --�-- -�,��_ . ..I ❑ . sauce to nearest lot gine- ----------------------------- 4 - s - Remodeiin ,and/orx repairing (describe):_ - --- --------------------- - ---- ----- - - ------------ - _ _ _ + y --------------- �'-::"'Ira _�• '------�-------------""------------------------------ - --_ -- --- ------------------ - ----'- ---- liat-6n and {hat'the wor will be done m� brdance with Sanaquin County y r. F o k fne Sanloaquin'Local Health�Dtstrict. hereby cerci y that have_pre are is app i ances, Sta V. ' • _ . .. . ,Wrjam - : : - -ordins (Owner and/or Contractor) e----- _ � __ ---�-" " -- -- ".............. etc., can be placed on reverse side). By,-- buildings, [Plot plan, showing size of lot, location of system in relation to wells, FOR DEPARTMENT USE ONLY R _ '------ ------- DATE.------ f -' --._- ------------------- APPLICATION ACCEPTED BY----------- --` ----•-------------- _ DATE_-----------•------- -- _-._____________________________________ __ 9 ' _ DATE--- -------------- ----------------------------------------- REVIEWED ------ ---------- ----- ---- ---------- BUILDING PERMIT ISSUED-- --------------------------------- ------------- --------- ' _`1, ---- -- ------ REVIEWED By__ qV . _ --_--._..__ • - __ Alterations and/or recommendations--------------- --.-----�- - - --•-"-- ---------- ----_----____--- ---- -----------•- - - - - --- - .. „-. a . .�.a• ti r1 �V L .e» .r - _,.. �.} a Date. -- -- -- 1 FINAL INSPECTION ' N JOAQUIN LOCAL:HEALTH DISTRICT -� 205 west 9th Street 300 West Oak Street 124 Sycamore Street_ Tracy,California 1601 E.Hazelton Ave. Lodi,California Mnteca,California Stocklon,California _ li F.P.0 O.