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• <br /> FOR OFFICE USE: <br /> ------------------- --------------- - ------------ <br /> ................................................ APPLICATION FOVSANITATION PERMIT Permit No, /,�_p <br /> -------------- ..---.---... . .... (Complete in Duplicate) Date lssued/,./.f:�_,X.�_,5� <br /> ......................................................... This Permit Expires I Year From Date Issued <br /> I I <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described <br /> This application is made in compliance.with.County,Ordinance-No. 549. <br /> :5,0 It <br /> V_*Ot �Y, <br /> JOB ADDRESS AND LOCATIOR1 t <br /> Lev <br /> Owner's Name---------FR_Aj4-zi_A......_Bi��........ ...........j�__....... Phone.--------------------------------- <br /> Address......J)W/....Y20.....14 MURRlY.....M---------------------8P61.V_- <br /> - - - - <br /> Contractor's ---------------....... <br /> ................ ..........................................wifffm.... Phono...... .......................... <br /> Oor-.- -rig-igrejM RAI <br /> Installation will serve: Residence E] Apartment House E] Commercial Trailer Court [I N Other ❑ <br /> Number of living ursts:,-_. Number of bedrooms Number ofbathis _4C <br /> ___A <br /> ........ Lot size --- _ IS----------------------- <br /> Water SuPP ly:irublic systelMqrComm- uhifyoE]ystem Private Oj.Sap+h to Wafer Table 147 <br /> Character Jof sdil to a deplin 6nt feet: <br /> diN, Gravel E] Sandy Loam E] Clay Loam [] Clay 0 Adobe E] Hardpan 0 <br /> Previous APplicafion Madt �I+esldate 1 ............) !N, 21-_ON�arw Construction; Yes 2�'go 0 FHA/VA: Yes [I No [I-'' <br /> A A 4, <br /> TYPE OF INSTALLATION AND SPECIFICATIONS. <br /> 5 sepil r :3 _s <br /> ATI <br /> E-f-aRnlit" r c­ei�;pq� is avallZli—withiii- _0D fee <br /> Septic Tank: Distance rom nearegttl....51D...6stanqe from foundafion 10 M teris,---COW me-r-rK-- ------ <br /> artmeqt%Atz—-------Isi J 09 <br /> I f - �-X�xj---Capacity090.0--- <br /> N o. 6 1 c, Liq._id_d1P6_._... <br /> k __1%1 t D i s f a 3'-�l rfm 4,u r,d at i ---------Distance to nearest lot <br /> Disposal Field: Distance from nearest. ell__,57D--- in <br /> Number of vines------- .......�L f1hp Yy.idt�,,of trench 152— L )Len I ---------2132::�`....:Z�* <br /> L <br /> Der of fifer material.---- ...........Total Agfih!................ /0.40........ <br /> Type 8f filter rnatisrajll O.C-415... <br /> I a .1 n <br /> Seepage Pit: Distant, 10 nearest' ......IDisfance from-fo6ndAf1An_'_._.`�!"b'stanc'to earestlot line.---__--------- <br /> F1 Number.of Lining mafetial-------- ...SizbtiDjem ------------------------- <br /> Cesspool: Distance <br /> r res 11,_ I ......Distance from foShTISfi6rA_ _,_ �14_ALM,ihg Material--- ------------------------------- <br /> 10 <br /> Dellth------- ..................-------------Aicuid Capacity............................gals. <br /> 1­1 Size; Dia a er.......... . ..... <br /> Ileilik <br /> M I <br /> U I <br /> Privy: DisfalA from nearest w 11....._._.___........1..._W ....................Distance from nearest building.-......---------------------------- <br /> nce to nearest lot line----------_----------------------------------------------------------_--------------- ......................................... <br /> Disfa <br /> Remodelingand/or repairing (describe):-..`----------------....--.....-........ --------------------------------- -------- -------------------------------- <br /> I <br /> -------------------- <br /> I...........................-----------------------------------............................----------------- ..................................................... <br /> .............. ...... .......... <br /> .............­................................................................... ....................... ........................ <br /> .............. -- --------------- ---------- ......._-------------------- <br /> 7;1------------------------------------------------..............------------------ <br /> I hereby certify f6at I have prepared this application and that the work will'te done in accordance with San Joaquin County <br /> ordinances' Sf a and rut ' and re ulations of the San Joaquin Local Health District. <br /> (Signed)---- <br /> - -- ---- .. ..............-------- --- --------I.... ............. ---------------------1------------------(Owner and/or Contractor) <br /> ...............AV <br /> (Plot plan.'showing seize of4, ot. location of s fem in relation to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ON11CY' <br /> APPLICATION . <br /> ACCEPTED BY._:��f.?A.0_.e............................................. - DATE..........11 ................... <br /> REVIEWREVIEWED` BY.'----------- .......... ...... --------- - ---------------­ ------- DATE...._............... ---------------------------------_ <br /> BUILDINGIPERUT ISSUED. ----------------- ------------------ ................_ DATE---------_. "--.--'..---'- .. .........--........ <br /> AlterationsndEr—recommeiiditions:............................. <br /> ..................................... . ------------- <br /> ------­------------------------------------- <br /> -------------71------ --------- <br /> ...................... ------ <br /> ---------------------------- ------- --- ........ ................................................ --------------------------- <br /> ................... - -- -- ----- - ------- --- <br /> A......... - - -- _ - <br /> - -------- ------- --_------------- --_------------ ---- <br /> -- -- <br /> ........... <br /> FINAL INSPECTI�0_`,:t - _ 990-- ---'-------- - Date......... <br /> .1-2 - <br /> Z............I------------------------ ...... <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E.H..0cm Av*. 300 West Oak Street 124 Sycamore Street 203 West 9th Street <br /> Stockton,C.Ilfemi. Loan,California Manteca,California Tracy,California <br />