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CE USE: .. Permit No. .��---Y--=-� :::FIICE ------------- ----- APPLICATION FOR SANITATION PERMIT ----------- (Complete in Duplicate] Date Issued This Permit Expires 1 Year From Date issued PP A {kation is hereby made to the San J with uin Local Health District for a permit to construct and install The work herein described. This application is made in compliance wi Y 9. TIONff�� o--- ---- - JOB ADDRESS AND LOC �~P _ --------------- Phone------------------------------------ -------------------- ---------------- ---- •------------- --- --- -- -- Owner's � -— - r -- . Ph one 1 ••---------- Address - --- -- ..----- Contractor's Name------- � ` -•-------- --- - O}her: Commercial Trailer Court ❑ Motel ❑ Installation will serve: Residence ❑ Apartment Nouse ❑ ; . Number of living units:----- Number of bedrooms '� ....-_ Number of baths __ of size ____-____-.�y----------- Water Supply: Public system ❑ Community system ❑ Private [!rDepth to Water Table -------- f� f a depth of 3 feet: San ❑ Hardpan ! d Gravel ❑ Sandy Loam [ ❑ Clay Loam Clay AdVA.❑ s E] No[ICharacter of soil to New Construction Yes ❑ No El FHA/ ` Previous Application Made: (If yes,date......... -----) No ❑ : I TYPE OF INSTALLATION AND SPECIFICATIONS: (Na septic.lank or cesspool permitted if public sewer is available within 244 feet.] , + ✓ Septic ank: Distance from nearest well--_-------_Distant from foundation cle ---- -.Material_.___...-. • � _Ca acit h; bO - --- �/� Size S� Liquid depth rid P Y L� No. of compartments os Field: Distance from nearest well.-S49-"---.Distance fromeach line foundation---- --W dth oft trench ---o nearest i lines_-___--__-•- p Length of ea Number of lines------------ ---- -------------- g s Total length.1,P.4------------------------------ Type of filter material------- LR�. -.-Depth of filter material --------DistanJto nearest lot line................. Seepage Pit: Distance to nearest well---------- ---------Distance from foundation----------------_._. Depth_-_.---------------------------- Number of pits------------------, 4 Lining maferial.....-.................Size: Diameter------------_--�---- ❑ Distance from nearest well_-" --_..-----Distance from foundation--------------=----Lin"sng material els. Cesspool: --_Li Liquid Capacity----------------------------9 Size: Diameter---- ---------------------e-- _.-----Depth----------- ------------- `� ❑ ' Distance from nearest building----------------------------------------- Distance -__------------------------- ------- Privy: Distance from nearest well----- ------------------- Distance to nearest of line...... -- e I ----- El Remodeling and/or repairings(desc ibe): 'i - -------------------- N-C— . ------------------------ ---- . .................................."........__..-..-., ..------------- ...................................................................................:.....................-1; I ___ _____ ... . ......... . ............ ...._.....-_.....__...-...__-_..__..__._.-.._.......-----------_.._--..-_._-._.._..-....-...__.--..__..._....._.. -.-.._..._.._..-..--__...__..._.. I I hereby Lerthaave prepared this application and that the work will be done in accordance with San Joaquin Count ordinances, StS. rules and regulations.of the San.Joaquin-•L"ocal Health District. _--" t- and/or Contracto (Signed) �g )---------- (Titl ---------------- -- -Uf ------------------------------------------ e)BY=(Plot plan, showing sixe lot, Iota#i 'elation to wells, buildings, etc., can be placed on reverse side]. FOR DEPARTMENT USE ONLY U ----- --------------- -------------- DATE.- Y3 7-------------- ---------- APPLICATION ACCEPTED BY- . --_-- --------------------------- - ------------------- -------- BUILDING PERMIT ISSUED----------------------------------------------------------------------------------------- DATE------------�i-- ---------- ------------------------------- BUILDING ---- -- -------------------- ------ ---------- -------------------------------------- ---------------------------------------------------------- Alterations and/or recommendations______________________________ - --------------------------- ----------------- - ------------ ------------------------------------- --- L 19, - '' ------._ - FINAL INSPECTION BY:_A_4;"_ _ ----------- -.--_-- ---- Date------ ------- --. .------- --- --- -------- - SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Ha:ellon Ave. 300 Wast Oak Street 124 Sycamore Street 205 West 9th Street Lodi,California Manteca,California Tracy,California Stockton,California F.P.0 O.