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.rte -- FOR OFFICE USE: - -_-.: --- Permit No. __--_ 5 3 _ APPLICATION FOR SANITATION PERMIT T k�z --- } -• ------- ----- - -.�4 -... ' (Complete in Duplicate) Date Issued * = k and install the workhe a` lescn T-------------- --- This Permit Expires 1 Year From Date Issued p, 3 Applieat-pn is hereby made to t e San Joe uin i-o�al ,H-Alth DistFtiV6\r% ermit to construe gibed`' This:application is made in compliance with County O dinancetNo. 549. �L� � 11llt< JbB ADDRESS AND LOCATION--S.I�1�--- � /aLP(�? ...E.� 1./ �'7 ------�--=- L.Y....-- Q .. ...... ' Phone._5 - --- '.;Owners Name-------._ -_ . . :- -�-t 4�•--j -••--••------ ---------- -------------- -----------� ------•--------- -•-- •--•-•�- --------•- . I bF W_ddra ------.----------- l£... ss-- `. _ n --- rphone,-f._------•-----------•------:-. contractor's NameC� L {...+ ❑ vlo#el'`p Other r Installation will serve: 'Residence ❑ Apartment ouse ommercial Trailer Court ❑ l-7 t' Number of bedrooms � - Number of baths -3--- Lot size,._+ __�_�r�� ---------------------- Number --------- ---- Number oT living units: _ I -Water Supply: Public system ❑ Community system ❑ Private Depth To Water To e +y � � l C4 aracter.of soil to a depth of 3 feet: Sand ❑ Grave! ❑ Sa y Loam ❑' C!a Loam la., Adobe .Hardpan P&vious Application Made: {If yes date--------------------{ No New Constr-uc on Y5 s NoY❑ f HA/VA: Yes ] No ( VJ 'TYfE.Op INSTALLATION AND SPECIFICATIONS: � * (No se tic tank or cess ool arm+tted if public ssewer is arailablt3 witkinF200 feet`)' Septic. ,nk: Distance from nearest well----------------Distnce frm foundation--------------------Material.. _--.-__ ----- i Size_ p=" ==Liquid-depth -i--.-.Capacity.. ------• i No. of compartments--------------- ---- ------- W -._--_-DistanceA nearest lot,line j� -� sposaIr. Fie Distance from neares# el'�Q Distana from foundation --_J0� -------Len t}lof e�achline-----� .--_---- Width of trench. ----- - •--- Oii N Number of lines-- ._-• --------- 9 -t rr'-- t .• .; �pD _ Type of filter material..: rl Depi f filtermAtenaL_ .-�. _________.Total length_____________ / / - R rom f and ln_.../_ _�---.D�stance nearest lot line_---- _.� = a Seepage Ft Distance to nearesfi wekLR-lQ---�__ _-- �- --_-Distance ` Number of pits------ � j5---- Depth- - _*----__Lming aerial_. _ __ - Sizer Diameter_ ___.._ `�+•-�nee rom foundation vcK_; Cesspool.: Distance from nearest well------- --__-•--Dista dation--------------------Lining material----------••------_-----_..-----....- , ',❑ � Sizer Dia �tier---------------- ----- - -D e_, - - -- ------Liquid Capacity------------------------------------------- Pals. p - ' ___ it_-.- -- _--Distance from nearest building � r+vyt <-1 Distance from nearest well - _ _.. .. Distance to nearest lot line.. 1 17 140 � �+ F relingaricAk /or repairing (describe):_ F l r Re od` y .. . i ---------------------------- i �-� � - ------------------------ _�- _- --- = = s 3V -------------------------- ---------------------3 � - t " p --------- ---------------------------------------- f__ i[_ _ __ __ w _ - c I: hereby certify that I have prepared this application and that therk will be done in accordance with San Joaquin County ordinances, State laws, and rubs and regulations the San Joaquin Lac'al Health District. . /� ? { mer a d/or Contractor)',. - P.. `- 1t/.LT C- - px e - Ow (Si ned) - - / 14 ---------------------------------4, - � r _ �--- - = Z= (litl® -�: - . gY •-= , Pat lah,, showing size of ,,location of system in relation to wells, buildings, eetcbe placed on reverse side]. ( ; ! I i, �,.,xY.. FOR DEPARTMENT USE ONLY . . ,u .. r tip ^ . sT - . C - r-I - --------- -----�__-_-- ----____ DATE------ 7_/7-T ---------- - DATE----------------------------•- ------------------ .-------PP �WATION ACCEPTED 13Y-------------AREVI= ED BY---------- ---------- h ; n and/or recommend'ations•---- --------- ------- --- --------------- --------•=-•--•-•-----....---------•• - BUILDING PERMIT ISSUED--:---------------------------------------------------------------------•-------------•- DA •-------•----• •-•-------•-----•------------------------------------ ----------- --------------•-------- ! AFteratio s / . -I � -...----- ---------------- - ; i Rli, - -----------------------__--------•------• ;-- ------•------•--------•----- - --------- -------------------------------- ----- ----�'FINAL lNSPEC --�- SAN JOAQUIN LOCAL HEALTH DISTRICT. 4°= ( + i 130 South American Street 300 West Oak Srreet 124 Sycamore Street 205 West 9th sheet' m Lodi,California Manteca,Califorct Tracy,California Si Stockton,Call fornia ES 9 REVISED B-59,.2.A 5-452-ATLAS ~,t. ,"-. � �� . ��mow' _:�.�.•_ • _.