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FOR OFFICE USE: � q �.. ��*� -21 1_0 /FOR � /G/ Permit No. .._�Ar-f- ff%may -----_----------_-- .._/l'�° APPLICATION FOR SANITATION PERMIT Q�� - ------ -- (Complete in Duplicate) Date Issued --- --- "----------" This Permit 'Expires 1 Year From Date Issued ,q finance No. for p gibed. Application is herebymade to the San Joaquin health District fora perm #o construct and 'install the work harem deet This application is made in compliance with County o 7"e • __--------•-- JOB ADDRESS AND LOCATION.. Phone-----------------------•------------ Owner's Name...... __.____-__------ Owner x . ____________________.______.___.__,__----__.- Address------•---•.-_.._� �ZZA; � one..----------------r-- ----- .3. : Contractor's Name------- -- ------•----------- _ Installation will serve: Residence Apartment House Commercial F1 Trailer Court ❑ Motel [3 Other [_1 Number of baths -1----- Lot size --- ---- Number of living unitsI i : ._---- Number of bedrooms _ -- /f De to Water Table& _ ft. l Water Supply: Public system ❑ Community system ❑ Private E] Depth Clay Loam ❑ Clay ❑ Adobe Hardpan ❑ Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam❑ y No T Previous Application Made: (If yes,date--------------------) No [ New Construction: Yes E!rNo E] FHA/VX Yes ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.). ti�n_ " fMaral_-_ Septic Tank: Distance from nearest well Distance from foundaCapacity__fp94--` k_ nts-..-- ---2. Si _ lGud de }h l No. of compartme ------------ _ 2 �� Disposal Field: Distance from nearest well_._`.J___.---Distance from foundation_1_;__y ------Distance to nearest lot fine- " Number of lines------ ------ --- ----Length of each line---��---------- -Width ofg#renc� -- - - ------ r - - --------------------------- Type t Type of filter materiae- - ---Depth of filter material..../__�._ .....Total lent _____ _ _____ _ ________ t3 "..".. De th_. 3"�� Seepage_Pit: Distance to nearest well----'gin n�Dateraial _ und5 zle:nDiameter"- Distance to nearest lot Number of pits----I-------------- g Cesspool: Distance from nearest well-----------------Distance from foundation.__.------------ Linuid Capacity gals. 00 ❑ Size: Diameter"----------------- ------- -----------Depth--------------- ------------------------------------ a P y-------------- X - ---- ----- ----------------------- Distance from nearest building------ Q Distance frorri nearest well----------------- ❑ Distance to nearest lot line- ------ --------------------------------- - --- --------------------------------- Privy: --------- . �:------ _ Remodeling and/or repairing (describe}:-.____:. � _ _ --�------ --- - --- -- -- - - All- ---------------------- . =---_ I hereby certify that I ave prepar d this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. -----------------------------------------------(Owner and/or Contractor) Si ned ----- --- --- ( g ------(Title)--------- -------- -------------------- ----- - ------- BY= (Plot plan, showing size of lot, loc tion of s stem in relation to wells, buildings, etc., can be placed on reverse side). l FOR DEPARTMENT USE ONLY loll APPLICATION ACCEPTED BY_..__ _. -------- --------------------------------- DATE --------------------- ----- DAT - REVIEWED'BY-----------;.--------------------- ---- , �J- ------------------- DATE----------------------------------------------------------- '` BUILDING PERMIT f5SUED--------------------------------- ----" t ----------- ----•----------------- �� , - Alterations and/or recorimenda+ions:.-.---- --- . ----------------------------------------------------- -------------------------- ------- ;. ---------------- r:.. ___. __ _. __ " i ------------ , . � � Date---- - --12/9/49 -------- ----- CTON FINAL INSPE r SAN JOAQUIN LOCAL HEALTH DISTRICT r 205 West 9th Street +r300 West Oak Street 124 Sycamore Street 1601 E.Hazelton A5). } LodiCaliforniaManteca,California Tracy, California , . Stockton,California C