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a� FOR OFFICE SE: S � s ---- , ,�_.-! crj ( , .-.?PLICATION FOR SANITATION Ph, ,`AIT Permit No. .......� ....... ----------------------------- -------- ------------------ (Complete in Duplicate) /// --- 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 made in compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION---- 2660 Turnpike Road___-9__.Stockton __ - ------•---.. Owner's Name.-• ------------------------------------------------------- ------------------------------------------------ Phone.P. ......5621Q-------- Address-------•-••----SaMe-------------•---------•---•------ .. . --•---------------------•-------•---. '------------------------------............................. Contractor's Name...........The---DAY---&...Kalil...>aeptic.__Tsank-.-QerV-iD-e-----------_-----------_--. Phone----BQ---fSaakl.---•-- Installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ®Labor Camp Number of living units: _'k____ Number of bedrooms ________ Number of baths __4�___ Lot size .......3__.ACX'-C'r�i________________________________ Water Supply: Public system ❑ Community system ❑ Private [Z Depth to Water Table __.-Oft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe[K Hardpan ❑ Previous Application Made: (If yes,date____6,/1 ,} 31��❑ New Construction: Yes ❑ No [Z. FHA/VA: Yes C] No E]TYPE OF INSTALLATION AND SPECIFICATION s (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well_________________Distance from foundation--------------------Material________-______._______-_-_--------_-_•-___.--_-. Egisting No. of compartments--------------------------Size--------------------------------Liquid depth------------------- ---Capacity....................... Disposal Field: Distance from nearest well---LOW__Distance from foundation----13-1--------Distance to nearest lot line._.3Q�..,. n ti Number oflines_______-.2______________________Length of each line....... t Width of trench.___...._._�x_,2- E�sting - g 5-----•--•--«---•- � & ADD Type of filter material__c�_.e_p-t-C___RkDepth of filter material----------1$__-----Total length------3_Q ------_----------_......... Seepage Pit: Distance to nearest well-------100t___Distance from foundation...1.Qt.........Distance to nearest lot line.....3.Qt_-- E®isting Number of pits--------P------------Lining material---R04k-------Size: Diameter-------- Depth---------2-5_T____----------- Cesspool:' Distance from nearest well_________________Distance from foundation--------------------Lining material_______-__---__-_-_-__---•-__--_----_ Size: Diameter---------------- -----------------De th----•--------------- -•------- ------ ------Liquid Capacity............................gals. .Privy: Distance from nearest well-------------------------------------------------Distance from nearest building--------.................................. ❑ Distance to nearest lot line--------------------------------- ----------------------------------------------------------------------------------------------------------- Remodeling and/or repairing (describe):-------------------------------------------------------------------------------------------------.......................................................... ------•---------------------------------------•------------- -----------------------------------------------•-•----------------------- -------------•--------------------------••------•••----------------------------------- I hereby certify that I have prepared this application and that the work w I be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local alth District. 51 reed `�`he._DAY `i'�t�k Lepv � . (�Contrac+or( 'g ) - --------------------------- ) By:--------------------------- ------------------------------------------- -- ----- -------I-------(Title)---•----------- ------ (Plot plan, showing size of lot, location of system i r bui i gs etc., can be placed on reverse side). FOR DEPARTMENT U E ONLY APPLICATION ACCEPTED BY-------- =� - --------------•---•---•-------•------•------- DATE---------- ------------------------ a - - REVIEWED BY------------------------------------------------------------------------------------------------------------------------------ DATE.----------------------------------- . ---------------------- BUILDINGPERMIT ISSUED---------------------------------------------------------------------------------------------------- DATE------------------------------------------------------------- Alterations an or recommendations:----- ------- ----------- ------ ----------------------------------•-------------------------------------------------•------••-------•-------•--• ,{ .............. ---- ------- - --- -----------------•--...-.._.-------•---------------- ------------------------------ -------------------------------------------------------------------------------------•---------•------•--•--------•----------------------------------------------------------------...._----.. FINAL INSPECTION BY:.......... ... A--5- ------ a ----------- -- Date--------- `'rle:� ------------------------------------------ SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 west Oak Srreef 124 Sycamore Street 305 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California ES 9 REVISED 5-59 2M 8-61 ATLAS