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APPLICATION FOR SANITATION PERMIT *��btmit No. ____G .._Z <br /> (Complete in Duplicate) ` c� <br /> Date Issued ___.1 <br /> 14?� 10?0-0,6 <br /> Applic&ion is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made incompliance with County Ordinance No. 549. on North side of North Ave ' Manteca <br /> Lot 46" {6th. place east of Hi Way 99 on North Ave. I;anteca <br /> JOB ADDRESS AND LOCATION------------------- - <br /> Mr. Jack Tomlinson <br /> Owner's Name---------------------------------------- -------------------•-•-••------- ----------------------- -------------------------------------------- Phone.---HO---4-5095.---- <br /> ----------- - <br /> Address--:________-_ 21 1 E . Myrtle Street. Stockton <br /> - <br /> PA�xsx INc, xo 6--96x7 <br /> Contractor's Name------------------------------- •---------------------------------------------------------• -------------------------------------------------- Phone----------------------------------- <br /> Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other <br /> Number of living units: ___ Number of bedrooms __ -__ Number of baths ---3'_. Lot size ----------- -2------40 7,Q0 <br /> Water Supply: Public system ❑ Community system ❑ Private)m Depth to Water Table ......... ft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam NX Clay Loam ❑ Clay ❑ Adobe ❑ Hardpan ❑ <br /> Previous Application Made: Yes ❑ No M New Construction: Yes [Z No ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) R <br /> Septic Tank: Distance from nearest we 501. lot <br /> frglp foundation__._ -�_t_____-M�erial__ C___BT Brick <br /> bb 770 !ice <br /> Nn. of compartments--------------------------Size___•-----�--------------------Liquid del th--------------------------Capacity---E�OO Gals <br /> Disposal Field: Distance from nearestYweil_..50.____-_Distance from foundatio R_.2�--___?Distance to nearest lot line______ ______, <br /> Number of lines------2 --Length of each line--_7� &-_2S---Width of trench.__---4----- <br /> T e of filter Depthmaterial---1 ____Rk---- of filter material_-18-_------------- length___-: _-----------_-------------- <br /> Seepage Pit: Distance to nearest well----------------------Distance from"foundation--------------------Distance to nearest lot line__-_____________ <br /> ❑ Number of pits______________________Lining material-----------------------Size: Diameter-----------------------Depth__-_---_-_-___._ <br /> Cesspool: Distance from nearest well-----------------Distance from foundation-------------- material-________.____.__________-__________. (� <br /> Size. Diameter------------------------- <br /> ------Depth---------------------------------- ----------------Liquid Capacity----------------------------gals, <br /> Privy: Distance from nearest WO l________________--------------------------------Distance from nearest building------.----------------------------------- <br /> 171 <br /> ---__.______-______-___--_-_- -.❑ Distance to nearest lot line ------------------•---------------------------------------------------------------r----------- <br /> S ecifications approved for a 2 bedroom house <br /> Remodeling and/or repairing (describe) P •------- !---------- -----o •-.P� - -----•-e_ ---------------------------------------------------------------------- <br /> on FHS sale of said:h-ouse. <br /> ----------------------- <br /> ------------------------------------------------------------------------------------------------------------------------- ---- -------••----------------------------------------------------------------------------------- . <br /> I hereby certify that-1 have Aegula <br /> plication and that f work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules of the San a in Local Health District. <br /> Sined PARRISHIN 9 )-------------------------------------- ---- ------ ----------- ---- -----------------------------------------------------•------------- Contract--(Tit le)Estimator -B or'. <br /> (Plot plan, showing size of lot, locin rela ion wells, buiidings, etc., can be placed on reverse side]. <br /> FOR DEPARTMENT USE ONLY <br /> f <br /> APPLICATION ACCEPTED BY------------- - - - --------- ---•------------------------------------ DATE----------- <br /> REVIEWED BY------------------------------------ <br /> -------- DATES <br /> BUILDINGPERMIT ISSUED.......------------------------- --------- ----------------------------• -•-------------------------- DATE.--------- <br /> Alterations and/or recommendafions:--------------------------- <br /> -------------------------------------------------------------- <br /> --------•-----------------• —---------------------------- --------------•--------------------------------------------------------- -------------­---------------------------------- ----------------------- <br /> --•-----------------------•--------------------•---------------------------------•------•-• ' <br /> -----------------------= - ----.�----.-.-------------- •----------- •-------� �� ----------------------------- <br /> ----- <br /> FINAL INSPECTION BY: TM Date1-14-7121.--------------------------------------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> ES-9-2M � ' Revised W-2100 <br />