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t� '1SI T' Lhereby Permit No. .- `2-71.6APPLI ATION FOR SANITATION PERMIT r (Complete in Duplicafe} Date Issued ---- -fApp ication ito the San Joaquin Loca! Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. f JOB ADDRESS AND LOCATION_____ _ Phone • - -- ---- - - -... -----------•--------------- Owner's Name--- �/f/_ ,-Ct - Address �°,''�52"a✓+ •----------•-- --- ...--------------------- --- - ---- } r � .... Phone. Contractor's Nam . 1 Commercial Trailer Court ❑ Motel ❑ Other ❑ Installation will serve: Residence X. Apartment House ❑ ❑ •--- Lot size --"---1".. L�iS-.�--f•----------•-------- Number of living units: I---- Number of bedrooms _7✓hlumber of baths _� � ' Private Depth"to 'Water Table .,Oft. Water Supply: Public'system ❑ Community system ❑ �.' P ► ICla Loam Cloy Adobe Hardpan❑ Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ y. v ❑e❑ � I Previous Application Made Yes E] No New Construction: Yes ❑ No [� FHA/VA: Yes E] No [I t TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) t S c ank: Distance from nearest well-.---._-""__...__Distance from foundatin_ __ e-th_Material-.-- Capacity_______________________ No.rof compartments----- ------------------Size---------------. --------------Liquidp+/ f ` r• C ion -.""Distance to nearest loft line�lc�-----• sal Field: Distance from near --- ----------------Length of each line__._____"" (�------- f \ length ! Type Nuof mber s-t- -l.___. PtC/�-Depth of filter metenal......��l6s-:Total __ _"c.'?O" ------------ -- Distance to nearest lot line__1s1------ v6 �G r page Pit: Distance to nearest well__._t______________Distance from foundation.._ Depth__.�tS�--;-----"-----=- Size: Diameter___ . Number of pits.._--/-------------=Lining material-- -- �- Cesspool: Distance from nearest well.".............. Distance from-found material...______.____.___.___._-.__-------- --•-Depth.-------- --------------- --------t -•------- .Liquid Capacity ----•gals. ❑ Size: Diameter------------------------- Distance from nearest well---------------------------------------------- -Distance^.from nearest,building.__.______._.___---__.____"-.._--.____-_. Privy: ------ - --- ---• lj - -•- Distance-to nearest lot line_____________________---------------------- --- -, ------• Remodeling /or repairing (describe :------ -- • - - - ----------•---------------- ------------------------- - i!,n ----� - ---------------- t. r } \� 1 ______________________________________________-------- ______ I hereby certify that I leave prepared Ais-a'pplication a d that the work will'be done in accordance with San Joaquin County f� ordinances. Stafe laws, and s and regulations the-San.- ordinances. Local Hea�fh District. 07 1 - _.(Owper and/or Contractot� :'. (Signed)" By:._.. - f_ - (Title} (Plot plan, showing size of lot, location of system �ela`fion to wells, buildings, etc., can be placed on reverseside}. FOR DEPARTMENT USE.ONLY r� _-.--.----- DATE-.'.-----"----- = ------ ---- - APPLICATION ACCEPTED BY-------------------"-- -- —f DATE--------- ------ ------ , REVIEWEDBY- •-------------•----" --- ------------------------- ---- - - -- DATE-------------------------------------------------------------- - - ------- --- BUILDING PERMIT ISSUED____ _______________ -----• - Alterations and/or recommendations:._.:.. -"-------------•-----------------•--------- ------ •' . (jp�-- ------------ ---------- --------------�-- ;--------------- ---------.-------------------------------------------------------------------- __q = -----------_----------------- ------------ -----.-•-•••--- -------- -•---•-------- ------------ ------------•-----------•----•--- --------------------------------------- --------- -------------- ---- --- Date..."/. ------- _ --------------- ------ FINAL INSPECTION' BY:._ t ` • SAN JOAQUIN LOCAL HEALTH DISTRICT 132 S camore Street 814 North "C" Street 130 South American Street 300 West Oak Street Y Tracy, California Stockton, California Lodi, California Manteca, California Y• ES-9-2M Revised 1.57 F.P.CO.