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I `LIGATION FOR SANITATION PEP 'T Permit No. . 3_�d.....- (Complete in Duplicate) y Date Issued Applica+ion 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_/..._..._. .. "..............Owner's Name----- -------------------_------------------------ ---------------------------------------------PhoneA- T.- Address------�pp9zr � -e-.j Q�LQQ--�. ---- - �"- -------- Contractor's Name..._.. -ZL -- ----M"j-LA._---�_1-T!.-......---`v'C' --^^------ ------............-----....... Phone...A&..z_7j9_—/ Installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court [I Motel ❑ Other Ca/ jE-- Number of living units: .^-.... Number of bedroom?'- -. "Number o aths .r!u-Lo} szi ee........... _�....�AO�............. Water Supply: Public system ❑ Community systerivate Depth to Water Table -------- ft. Character of soil to a depth of 3 feet: Send Gravel ❑ Sandy Loam Clay Loam Clay Adobe [sj Hardpan ❑ Previous Application Made: Yes E] No [New E] ElE]Construction: Yes 0 o TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 Septic Tank: Distance from nearest well, Distance from foundation.../ .........Material------- size _. size � '-..U...X..Liquid d h.. �M.4_--- _.__No. of compaments._.. . s[� Disposal field: Distance from near st weIL1Q------Distance from foundation../9_........Distance to nearest lot line.___.5......_. Number of lines --- _. ._ .. . .._...Length of each line.. a Width of french_c; Vol Type of filter materia-e. Depth of filter material------.Q..��---.._Total length....... ........� . px.-x�.'- Seepage Pit: Distance to nearest well_.............._..Distance from foundation------------.......Distance to nearest lof ine_112,44,Jo Q Number of pits----------_. -------.Lining material-----------------------Size: Diameter.__._....._..._...._.Depth----- --- Cesspool: Distance from nearest well................Distance from foundation._.---------.._Lining material---------_----------.............._ ❑ Size: Diameter----------------------- -------------Depth...--- ---------------------------------Liquid Capacity---- -- .------------gals. Privy: Distance from nearest well-..._.._...._.._..__._._.............___._-.Distance from nearest building-----.__---............................. ❑ Distance to nearest lot line.------------------ -.............................y� . '. .. ..------ - - ..... ------------------------- -- - - ----------- ---...---- Remodeling end/or repairing (describe): rt T.�-c� -��-" r'c----- ------e--------------- -....---.....................----- ---------• 4 ......----...........................------------------------------------------------- --------------------`-------------------------------------------------------------------------------------------------- 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, f}Z DAY& NIGHT (Signed).... -....-..._Septic-Tank-Sosvice------- ----- ------ -- -- - -----.�Contractor) By: 1206 So.Eldorado HO 2-7046 _... (--- ---.--- t Lh ltl------ ---------_-..--._.---- ------------ �� S{ - .... - -.. _._ (Plot plan, showing size of to+,loc- a+ion o system In relation to wel , buildings, efa can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY---- - .._.._.k --- - - --- - .................. DATE---J W - - - -......_ DATE.... - - REVIE ED BY---------_-_. ..... .... ..... ...... . . � ISUED----- ---- ----------- ... ----------..... ...------.. ........ DATE---------- ------------... . . BUILDING PERMITS .. ... . .._ . ... .Alterations and/or recommenda+ions: - ------ ---------------------......._.......1- ---.......- ... -- - - ---------- -------•-- ..................-------------------------------------.....------------------------------------------------ ---............-------...--------•--•-------....... ..................... ..........------------- - - -----------•---------- ------------------------------------------ - ------ - --------------- -- --------------------...................................... -........... --- - -- ----------- --�1 r --.......__....... - -- - -- FINAL INSPECTION BY:.---S Y...�........... ....................._. ... Date....-- -- -- - --'� ------ - SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street. 300 Wesf Oak Stree+ 132 Sycamore Street 814 Norfh "C" Sfreet Stockton, California Lodi, California Manteca, California Tracy, California Ems" 9 145446 ATWDOD