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FOR OFF CE U ------------ ----- ----------- --- - U APPLICATION FOR SANITATION PERMIT Permit No. . � _.__..., -- --- ------------------------------------------------- (Complete in Duplicate) --------- - ---- This Permit Ex fres 1 Year From Date Issued Date issued -__-- Application is hereby made to the San Joaquin Local Heal+h 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.._______2326 _Jail Aver - Owner's Name Ralph McBride HO 21 20 ------------------------------ - ------------------------ ------ Phone-H.0--- ------------- ---------------------------- 92-5-So" Rendon ------ Contractor's Name-The--DhY & NIGHT Septic Tarek Service HO 638�.�. ------------------------------- • -------------- - -----•----- - ---------- ----------- Phone. --- -------...- - -------------------------- --- - - - Installation will serve: Residence 0 Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: __ '__. Number of bedrooms _ _-_ Number of baths ---;-._ Lot size ------ a-___---- Water Supply: Public system.Qg Community system ❑ Private ❑ Depth To Water Table bQ_-- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe'5 Hardpan ❑ Previous Application Made: (If yes,dote____________________) No ❑ New Construction: Yes ❑ No 61E FHA/VA: Yes ❑ No ❑ . TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within.200 feet.) Septic Tank: Distance from nearest well------------------Distance from foundation--------------------Material ExLgting No. of compartments....----------------------Size--------------------------------Liquid de th------ ----Capacity Disposal Field: Distance from near st well__Not7ta;___.-Distance from foundation...;-q!......... to nearest lot line... _._5�...... " �' g Number of lines-------------------- ------------Length of each line-- -20t._-.__-- -- Width of trench.----2}t`t___....--------....-_-- I & � Type of filter mate ria F!e-P��-- ---Depth of filter material__._.-_��tq________Total length------------------------------------------ None __.-._____-��T_-___-- _ Seepage Pit: Distance to nearest well-None-----------Distance from foundation----2Qf------- Distance to nearest lot line.___5f-_---___ "V 19 Number of pits------ _______--_--Lining material-_SP�__�____Size: Diameter._331'_3 - Depth Z t--- - -�..---- Cesspool: Distance from nearest well----------------- from foundation----------_---------Lining material----------------------.-_______...___ ❑ Size: Diameter--------------------------------------Depth----------------------------------------------------Liquid Capacity ----•--gals. Privy: Distance from nearest well--------•--------------------------------.-_-°---Distance from.nearest building----------------------------------------- 0 Distance to nearest lot line________________.____--_ t + Remodeling and/or repairing )describe)__________________________ _ --- --------------------------------------------------------------------------------•--•-•----------------•-----------------------------------•------------------------------- --.._'--.--------------•---------------- hereby certify that I have prepared 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. (Signed)--TY-e---ICY------NIGHT-Sep�z---Tank Service ----------- -------- Contractor) ------------------------- By:---•--------------••------------------------------------- --------------------------------- Title - ---------------------------------{ )------------------- ----- - - - - .....--------------- (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY ---------------------------------------- DATE.. � 7 •_` - - REV IEWED BY----------------------------------•-----------------------------•------------------•-----------------------•---------------- DATE_------------ ------ BUILDING PERMIT ISSUED-----------------------------, •---------- -- DATE ---- Alterations/and/or recommendations:__._____ ..____._.l..------------------•-_-- _ _ �-- --- �' C� �r.�—cam GAG"'��"•'l�" ��_ - ��- ____________________3__... � --------- ._._ r _. FINAL INSPECTION BY:.----LLI .•._.__. ---- "�� Date--------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 west Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,6a11fornla Manteca,California Tracy,California I ES 9 REVISED B-59 2M 5-62 ATLAS � f