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--------------------------------------------------------- 1� -------------- ------------- - ________ _ --------------- APPLICATION FOR SANITATION PERMIT Permit No. ._.��?--�T� ------------ ---•-- (Complete in Duplicate) ------------ This Permit Expires 1 Year From Date Issued Date Issued ... ..__.6- Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This epplication,.is-made,in.compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION...___Maurland Manor Tract Na, 438 Trac -------------------•--•---------------- .............-•........................ Owner's Name..._Mr�---& Mrsa Leslie Johnston (CC Cunningham, Contr) Phone..---------------------• ............ Address--------------••---Z-am-e-i---Tx aay Contractor'sName___T_he_- A ..&•__NZGHT_•Se-F - _-Tank_-Service_-_ H0 6-3841--.-_ -------------- Phone-- I Installation will serve: Residence ...[Z Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of livingunits: I__. Number of bedrooms 2 1QOt X i . Number of baths Lot size -- .... 7-. .................. ..... Water Supply: Public system ❑ iCommunity system ZY Private ❑ Depth to Water Table Character of soil to a depth of 3 feet: Sand ❑ Gravel [Z Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe[K Hardpan ❑ 1 Previous Application Made: (If yes,date___________---------) No Qg New Construction: Yes ] No F] FHA/VA: Yes C-] NoE]TYPE OF INSTALLATION AND SPECIFICATIONS: f (No septic tank or cesspool permitted if public sewer is available within 200 feet.) �' C , .�,,C.� '! F'ar .. 1...-yam _+.a'�.. _ - - - _ �a._ a.. � '1 Septic Tank: D-istance from nearest well__-2()_O___. Distance from foundation._._ -1Q... \ rl 'q p -- - 1 --- Capacity5.44...1aa is � No. of compartments__' ______________Size�}.._. .x___g___._____-.L1 Liquid da th_.-_--�0---- - Disposal Field: Distance from nearest well___ _QQ`.-Distance rom foundation ___ O�_____. ' tance to nearest lot line...... [ C Number of lines----- -------- - -------------Length of each line-�-� __�_'r_ idth of trench.--------2�}!�---••- P 9 2Og p $Ott t g 't ----- See e e Pit: Dista Type oe tloEnear st rwell__--_-O- --k b stanceffromrfoundation...8 -----__-_Disal ncentohnearest�IOoNin.- ---8 WC R ock Number of pits__ `Lining material________________ ______Size: Diameter._______ 1 Cesspool:• Distance from nearest material---- from foundation__________ Lingka"2,rjal th-.-.`__� Al��_•_ ' �i ❑ Size. Diameter, Depth ---------------------------------------------------Liquid Ca aci - Prrvy. Distance from nearest well ____-_.-----------------------------------------Distance from nearest building ______________ ❑ Distance to_nearest lot line------------------------------------------------------------------- Remodeling and/or repairing d scribe):__- _damN1 --w! ------------------ f/ - ----------- -----------------------------------------------------------•-------------------------------------•--------------••-------- I 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)---Jha_DAY_ &-_NIGHT--- SeP;L1P---Tank--S j r_ry a --- - - ---.-------------------------------------(�+�r Contractor) By:........................ ...........(rifle)-------------------------------------------- ----- -- showing sire of lot-locatiion:of system.in relation to w s,_buildings,_ c., can 6e_placed_on.reverse side).- FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY----------------------------------------------------- --- - __P1---- --- DATE--------- �__Y _5- - - --- ---_.._.. REVIEWED BY ----------------------------------------------------------- DATE -------...-•------------ -- BUILDING PERMIT ISSUED...--•------------- -------------- DATE r` Alterations and/or recomme da :o __ - ------- ........I----------------------------------------------- ------------ ........... --------- --- - ---- --------------------------------------------------------------------------------- °-r'` -d' ?r l� qe -✓ L----- -- - ------- .._� ... .... .... i ---------••----•------ ---------------- R F1NAL INSPECTION BY:. -- ---- ----------- Date--------�- . SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 124 Sycamore Street w 205 West 9th Street Stocktonr California Lodi,California Manteca,California Tracy,California ES 9 REWSEP 8-99 @M 0-61 ATLAS w