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FOR OFFICE USE: �F - -- -------------------- �l APPLICATION FOR .---------- SANITATION PERMIT Permit No. ..c _ _ 3� I (Complete•in Duplicate) 1� 7 --------- - - - > �1, -- -- kl� Date issued -1�---�---•.- _ -..r This Permit Expires 1 Year From__Date Issued - i Application is hereby made to'the San Joaquin Local Health District for a[Mpermit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. P JOB ADDRESS AND LOCATION__ I -- ---h/,Q .7"fi 'Q k069V 7- Owner's Name--- f-G-- - ------ Oat, � - W. _-4,061 Phone4ko 7 �I V�- 4_ 67 Address--------------- �J -- - - - --------- -- --------• _ r- ' 2 t? i-••------••-.._.. Contractor's Name----------T---•A._fLR_ _5.0---- -- --------------- -------:---------------------------------------- ...... Phone_¢E2j9F6P_X---=-4" Installation will serve: Residence❑ Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other XA 'fl Number of living units: 16 ----- Number of bedrooms ........ Number of baths-------- Lot size -.- ----- -- --- --- __--__.________._.__._ Water Supply: Public system Community system [] Private ❑ Depth to Water Table 70_ ft Character of soil to a depth of,,3 feet- Sand ❑ Gravel p Sandy Loam ❑ Clay Loam ❑ Clay [] Adobe ' Hardpan ❑ . Previous Application Made: ,Iliyes,date........ 1 NoV New Construction: Yes)a No'❑ FHA/VA: Yes ❑ No jo TYPE OF INSTALLATION AND SPECIFICATIONS: r (No septic tank or cesspool permitted'if public sewer is available ithin 200 feet.) )C kC unclation_ 0.--- Mater<a -- Sep Tank: Distance of eompartments} ��Dz tante from f Liquid depth_,67Z-.---- Capacity_/�Q_4�'.A� 'h Number from nearest11well�_A/Z.'Distance from fou nciation__4-..___..Distance to nearest lot line__/V_**.... Ei -4( - f t i E. �} . Disposal Field: Distance rll lines ___ Length of each line_ .� ---__-`�-_-_-.Width of trench.. _________..__ Type of filter material----. . ... ....Depth of filter material_..-__�__g`___Total length______.__________1_fi__..__�___ p g lumber of near st wellW_.aJ/J�_--Distance( room f II nclationD 4eter_ Dista ice tonearest lot�e_1_Q_ ... Seepage Pit: Distance to plts -----------Lining material- - p I U Cesspool: Distance fi`om nearest well _______________Distance from found&ion.---------------- ..Lining material---___----_____:_..____._ [� Size: Diameter- -- --------- ----- ----- ---- -Depth--------- ---- C--- Liquid Capacity gals. i Privy: Distance from nearest well----------------.--------.----------.--___ -1-Distance from nearest buiiding------------_----------------------------. ,, El Distance to nearest lot line p------- ------- &4 .... ------- jM G Remodeling and/or repairing [describe]:--.-_. I _ --------- ---- - ----- -- - ------------------"_ *�- --- -------------- - - - I hereby certify that I have p red this application and that the work ill be done in accordance with San Joaquin County ordinances, State laws, and rule and regulations okhe San Joaquin Local ealth District. k4 _-Owner and/or Contractor (Signed)--------- --------------------------- ----- -- { ) B {Title) --- - - -• -------- r -- t (Plot plan, showing size of lot, location of syst in relation to wells, built�ings, etc., can be pl d on reverse side). FOR DEPARTMENT USE ONLY - = ---------------4----------- - - ---------- DATE-- -1� - APPLICATION ACCEPTED I - J--------- REViEWEDBY.- ------------'---_------------- ._---------------------------- ------------------------------ ------ -•- ---- DATE. ---- -- Altercations and/orTrecommDend! ! -----------M DATE. - ----------- ----------------------- I�ations:__!./- ._T� _.iGJ��-- ------- -- 'w p ----------------------- -- i� 4M------- ----------------------------------- ----------------------------------------------------- M - --------- ---- -------- --------•---------- -------------------------------- i ------------------------------ .�° ` l I �lI � FINAL INSPECTIC Nq — `� Date_ __._._.... -�- ------------- - -� -------------------------------------------------- SAN ------ -SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazelton Ave. I� 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California I� Lodi, California Manteca, California Tracy,California E.H.9 2M 1.67 Vanguard Press I� -