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--- ----- ------------------------------- ' ---- ---------------- ...�PLICATI4N, FOR SANITATION PLAIT SIT Permit No. ........................ ---- ---- ---- ----- --------- ----- --- {Complete in Duplicate) This permit Ex ires 1 Year Fram bate Issued Date Issued _4�_-/�--�� 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,.maderinzcomplian ith.County Ordinance No. 549. w ws.n/e1 r cru : ,.. (Windnill Cave JOB ADDRESS AND LOCATION t'_Atw--5 BOX 60 g,-� Stockton' Vulcan l3l zzo r-� H&V lark Inc; Island Owner's Name----- ---- ---------- ---- ----�----•-------------------------- --------------- Address - ----- Pe D Bax 53$6• San Jou$ :— ----------------------------------- Phone---52.59 Address----- = 18' �--- ----------------------- 'FSB eTO3C�- C8 it------05 ,.05)----------- x Contractor's Name The & NIGHT SC tae Tank 3erviee } ��,,_ ------------------------------------------------•------ V j ----------..P.-------- ------- ----- _� X66-38� © �. Installation will serve: Residence p - - - -� - - ------ ----- ------•--==--------- ----------------- Phone..----•-•--•--•------------•------ [ ❑ A artment House ❑ Commercial� Number o{ livin units: _� i �: ❑ Trailer Court ❑ Motel ❑ Other g _--- Number of bedrooms __-- ---- Lot size-__ Cc?'A>;�' Water Supply; Public system ❑ Commuhit system Y Y ❑ Private Depth to Water Table -------- ft. Character of soil to a depth of 3 fee+; zs. 1, a ", Gravel E] Sandy Loam 4 Clay Loam ❑ Clay Previous Application Made: If es, . °2�'/ 166' N� Y ❑ Adobe [] Hardpan ❑ Z I y tom . Ctsr N w fruction: Yes No TYPE OF INSTALLATION AND SP, GIFIC T Q S ❑ C FHA/VA; Yes ❑ No ❑ [No septic tank orate ss of permiffed ti public sewer is available wifFiin 200 feet.) 1 Se tic Tank: Dista Ep n e from nearest well- t. -Distance from foundation_._____-.- STIINQ No- of;Apartments- ' `' S• — --------.Material------------------------------------------ __ ize -- =- - --- -------Liquid depth- Capacity oni Disposal Field: Distances "rom nearest well. pis ee�f on, foundat' 20f & DAG �.. 1Dn _-----Distance to nearest f 30t I Number ,f lines__[--- +"----------- Length of each fine---$f7t________._, _ caw... Type of fihter mate�i6l-A.-__-.-.- " .-.Width of trench--- ----------- ----- -------- ---Depth of filter material-------------- Seepage Pit: Distance to nearest well- �` €., Total length Seepage °"�_-_D;�stanceyfrom+foundation--------------------Distance to nearest lot line_________________ _ ❑ Number of pits:.__.----__----___-_Lining material_-�.`- ----- Size: Diameter---------- - - ----Depth-------------- , Cesspool: Distance from nearest w til___-_-__--___._ --- Distance from foundation-------------- ❑ Size: Diameter.- ,A Lining material EJ Depth---------- Liquid Capacity - -------------......... gals. Privy: Distance from„nea est well . EJ --------------Distance from nearest buildin Distance to nearest lot line --------------- g ---------- ;. . ----- Remodeling and/or repairing (describe)-__ E_,AG� - ---- ------------- --- -- ------ ------ -�--- --- - I �tg---8Q.-1 8Q.-lin--ft drain--line o- c ---------------•---------------------------------------- p�13r-,for---2--bedroom---------------- tra lcr t Aa.aCjng--eZUti.ng Z-bedroom__tt ailerz. �' ------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------- - -------------------------- ------------------------------------------------------ ----------------- - t I hereby certify that I have prepared this application and thaf the work will be done in accordance with San Joaquin Count �,irr�dinances, Sfafe laws d rules and regulations of the San Joaquin Local Health Districf, y [Signed)-------= a !_ gEPT1C TA(lJk� : --------------------------- ---------------------------------------------------- � � � - �------------ P6+- --- ----------- -- --- -- - -- -- [Owner and�or Contractor [ . . plan, showing size of Iat, locatioh of system in relafion"fo wells, buildings, etc., can(bteleplaced on reverse side-- . "" err' ....FbR DEPARTMENT USE ONLY APPLICA IrfO_N ACCEPTED BY--,.- -�; REVIEWEDABY DATE_ -�4T�6 "�•"� !��, k ------- ---------------------------- ----------- ---- -- ................. ------- -------- - ----- - BUILD $1 PERMIT ISSUED DATE----- A Cera ions and/or recommendations::__��:-_-_ DATE___________________ 'I ----------------------------- - ---------------------------- --•- -------------•--------- - "'rr" '. -------K------- -----------------------!.n---------- -------------------- ------- FINAL INSPECTION BY .---_-. ----- 4,- ...... I SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Nazelton Ave. Strk 300 West OaStreet Stockton,California Lodi,California124 Sycamore Street 2 Manteca,California 05 West 9th Street F.P. Tracy,California C _ -� r