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qq FOR OFFICE USE: ` 7 Permit No � _ ./-_ 3 0 APPLICATION FSR;SAN(TATION PERMIT r � /L --- (Complete in Duplicated Date issued . - -.� � -_ jy-G 7.-- - This permit Expires 1 Year From Date Issued Application is'hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION__']----------- --7d4-South.-N+xthe �� gTx-AV-e-a StQG _OpLj,- - i. -o m3a------------------------• I Nrrs. C•--Ginelli Phone---------4--b 2-97 ----------- 11 Owner's Name-------•------------------------------•---------- --------- ---------------------------- Address--------------------- --------------------------- --------------------•-------- 4669607 ____ ---- Phone----------------------------------- ----•--------------- ---Motel Other [IContractor's Name---------------------•---•---- ---Perr-isl�--&- Iit6�--- s-.-.----------- Installation will serve: Residence 2] Apartment House ❑ Commercial F1 Trailer Court [3 Motel Number of living units: _---1.- Number of bedrooms ---2-- Number of baths --I--- Lot size ----------60.-1--150------------------------------ Community system ElPrivate ❑ Depth to Water Table ...-l�Oft. - Water Supply: Public system ® Y Y Sandy Loam ❑ Clay.Loam [I Clay E] Adobe® Hardpan E]Character of soil to a depth of 3 feet: Sand 171 Gravel ❑ anY Previous Application Made: (if yes,date-_-_-.---._:-..--- ) NoEj New Construction: Yes ❑ No a FHA/VA: Yes ❑ No ®. t TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) . $! s Septic Tank: Distance from nearest well from foundation--- -N,-------Material--- Liquid deptCapacity Y No. of compartments--------------------------Size---------- El ----•--- ❑ existing None Disposal Field: Distance from nearest well-----------------Distance from foundation_- ©e-----`==Disfiance to nearest lot line---- -- ___--. ® Number of lines- -----Q ------ Length of each line---)A ------------------- -Width of trench-.-.2��}- Type of filter material--------Ronk-----__Depth of filter material------18------------Total length-------_4Q�-_:------------------------ l Seepage Pi#: Distance to nearest well--------NQAP- --Distance from foundation---110-----------.Distance to nearest lot line_-5_-.--.----_ � ❑ Number of pits.-1--oI1.G-..----;_Lining material---_-='pCk-------Size: Diameter------------ 33.°----Depth------- -2 Cesspool: Distance from nearest well-----------------Distance from foundation_.------ Linu�id Ca acit gales. O ❑ Size: Diameter- --------------- ------ -Depth q Capacity ---- { ---- Distance to nearest lot line----------------------------------------------- ------ -- f ------------•---------------------•-------------------------------- f Remodeling and/or repairing (desciibe):----------------- U�? .6�flf3A.-- T_&].IIS@.-------------------- ' ;� ----------------------------------------------------------------------- E ----------------------------- -- --------------------- -------- �1 ------------------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County d regulations of the San Joaquin Local Health District. ordinances, State laws, and rules a1n (Owner and/or Contractor) t -- ------- ----- - , ------- --------- (Signed)-------------- • a�u^3'3sh--sS,- -Qll�s.� X>rilQ. ----- — PI'e8. miles es A. Prrish ;ft ._` ---- -- -- (Title) -----------------------------•---- ---- (Plot plan, showing size of lot, location of sy em in relation to wells, buildings, etc., can be place on reverse side). ( FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY--------------- -- ----- ---------------------- ------------------------------------------- DATE------ ---/ 1� ----- --------------------------- APPLICATION BY------ -----=--2--------- --- ----- -------------------------------------------- -------- -------- ------ DATE---------------------------------- ---------- ------------ ---------------- - BUILDING PERMIT ISSUED--------------------------------------------------------------- ------------------------------- - ---------------------------------- ---------------------- Alterati ns a d/or reco endations:--------- - --------•-----------------------------------------•-----------------•------- ---'----------- -------------------------------------------- ,[,, - � t T hI r ------- ` - e..--------------------------------- '� --�"`-------------------------- ------------------------ ---------------- ------ -------- --- . ---------------------------- a-�Date---------------- --- -�J-----�--- --- FINAL INSPECTION BY:--------- ' .-+--•---------------- SAN -SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazelton Ave. 300 West Oak Street ' 124 Sycamore Street 205 West 9th street Stockton,California Lodi,California Manteca,California Tracy,California i