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i..rJLICATION FOR SANITATION PEkvwlT Permit No. _A/7__�_� J' `��\ (Complete in Duplicate) � � __.�-"°" Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This a�plicati n is made in co liance with County Ordinance No. 549. J06 ADDRESS AND L CATION._______ s mane--and--Sperry Road ---- - ------------------------------------------------- Owner's Name--Johns-Manville Products Corp. of California ------------------------------------ ------ --------------------- -------- Phone )f---4-73.41---- ------- Address__.__P?O* Boa 1587 Stockton California --------------------------------------...---------------------- -T.R. McDONALD Sewer & Sentic Tank Contractor Phone.._.__ Contractor's hdame__-_ LA 3-8087 _ 3� -�1- Pa-so-----Nfodest-o;- California--- ------ -------------------------------------- ------------ --------------- Installation will serve: Residence ❑ .Apartment House ❑ Commercial ® Trailer Court ❑ Motel ❑ Other ❑ Number of living units: __--.-_ Number of bedrooms __. --- Number of baths . ----- Lot size approxe160_-acres--------------_.._.. Water Supply: Public system ❑ Community system ❑ Private ® Depth to Water Table !3?--- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay FL] Adobe ❑ Hardpan ❑ Previous Application Made: Yes ❑ No ® New Construction,: Yes [Z No ❑ FHA/VA: Yes ❑ No I TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) 3ep#ie--Tank: ---Distart-e-from-nares#-"t1_W-ADisfenee-fromfoundaf or_ t-...Mart8r; _Regd6A-s0nCr-et�- ® No. of compartments__ -----2_--------------Size-_171x6 XXV--------Liquid depth---.>r.--- tt-------_----Capacity30W_98.-o- v Disposal Field: Distance from nearest well-_600-ft Distance from foundation----31__ft__.Distance to nearest lot line.-3-70--ft. 171 Number of lines___.-__..�-_-------------------Length of each line____l00__ft-----------Width of french._*----------------------------- Type of filter materiall!^2!� toAe Depth of filter material___. _ft__ �Tetal length-_--11�_fto_________________�d Seepage Pit: Distance to nearest well__---- ----------_ ---Distance from foundation-----------.--------Distance to nearest lot line----------------- V� ❑ Number of pits----------------------Lining material---- ------------------Size: Diameter-----------------------Depth-----------------------------._._ \ Cesspool: Distance from nearest well-----------------Distance from foundation.__ --------------Lining material------------------------------------- 1 �_7: ❑ Size: Diameter---------------------------------------Depth--------------------------------- - - ---- --------Liquid Capacity.--------------------------gals. rn' Privy: Distance from nearest well------------------- ------ _________-.._____Distance from nearest building_-___.-_--__--_---__---__-__-_---_. ❑ Distance to nearest lot line. -- -- -----------------------------------•-----------------------------------------------------------------------------------------� Remodeling and/or repairing (describe) �c / c �Isz kl-zZ--------7�,S ----------------------------------� -- - - - -------------------------------------------- - - ----------- ----------------------------------------------------- ---- ---- Eatire bed excavated two (_ )ift, beyond and along each exterior ]leach line in the leach field 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. - - - - --- - -------------------------------------------- --- or Contractor--- -- -- ------- _ -- Owner and (Signed)--------------------------------------------- ( / By:------------------------------------------------- ------ ----- -------- ----------------------------------------------- -----(Title)----- - ---- - ----------------- ------ (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). F DEPARTMENT USE ONLY VhAPPLICATION ACCEPTED BY v 1�(/Int.(its^-'-------------•---------------------- DATE`S -' REVIEWEDBY------------------------------------------------------------------------------------------------------------------------- DATE---------- ------------------------------------------------ BUILDINGPERMIT ISSUED----------- -------------------------------------------------------------------------- --- . DATE---- ------------------------------------------------------ Alterationsand/or recommen dations:----------------------- ----------------------------••--------------------•------------------------•----------•---------•--•-----•--------------------•---•---- { ii ( ! – ! ---G- •--- ----------- ----------------------------------------------------- - -------------------------------------------------------- - - ----------------------------- FINAL INSPECTION BY:..- , � t� ------ - Date - ----- -- r SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2M • Reviseo 1.57 FT.CO.