Laserfiche WebLink
JOB "ADDRESS AND LOCATION. vti) <br />Owner's Name P6-1--- F-- tAi <br />Address..),?..OF <br />Contractor's Name <br />300 West Oak Street <br />Lodi, California <br />Date <br />SAN JOAQU NI MAL HEW M-STRICT <br />124 Sycamore Street <br />Manteca, California <br />FOR DEPARTMENT USE ONLY <br />APPLICATION ACCEPTED BY -7h1-1 F. -0 ' DATE. <br />REVIEWED BY DATE II - <br />BUILDING PEWIT ISSUED DATE. II <br />Alterations analor recommendations- <br /> <br />i 9 <br />FINAL INSPECTION <br />130 South American Street <br />Stockton, California <br />ESA, REVIISCO 0-55 F.P.CO. 21k4 41,60 <br />z <br />205 West 9th Street <br />Traci commie <br />1. <br />_ <br />1 <br />_ This Permit Expires 1 Year From Date Issued ma -li <br />This application is made in compliance with County Ordinance No. 549. <br />Applidation is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br />APPLICATION FOR SANITATION PERMIT Permit No. ' *--1 '.•:....:27:"..... <br />I - zug-z-04,-3, I <br />12 ,14 OF V6T1A1 <br />(Complete in Duplicate) Date Iss <br />..0, <br />4 <br />ed ... A 1 - -Li l <br />/09v/4 H r 17r <br />431aneMil-P T0411 <br />1 <br /> <br />3 A ...7, ! - 4 .k.‘ <br />;!!6 <br />Numb er of living units: Number of bedrooms ZNumb;r;f baths Lot size 11c <br />.10161._ • <br />t /1 <br />Water Supply: Public system 0 CommUraty 'syrtern,0 yA ,...Dapth to WateTable /5'ft I • <br />— <br />_Previous Application Made: Ilf yes,date • I No 5ef,le-w.COnstructiOn:_Yes'alo 0 HA/VA: Yeti 0 No El <br />TYPE OF INSTALLATION AND SPECIFICATIONS: • t <br />6 — <br />Swimming—A. <br />1 <br />OR OFFICE USE: <br />6IW <br /> Phone <br />t>64..E-1 -RAO cis cc=) <br />OVA.L.D • g7 • <br />Installation will serve: Residence 0 Apartment House 0 Commerciall:r Trailer 'Court-0- Motel 0 Other 4 • <br />togoveyeedjor4 4 - <br />Character of soil to a depth of 3 feet: Sand 0 Gravel 01\Sandy Loam 0 Clay Loam ErClajt.0 Adobe 0 Hardpan El <br />, <br />.(No septic tank or cesspii-or perAitted if public sewer is ar:eilable within 200,feet.) <br />Septic Tank: <br />Disposal Field: Field: <br />Seepage Pit: <br />Cesspool: <br />Privy: <br />0. <br /> <br />it t II ., Distance from foun ./C---''''CAlerrra CON C> <br />No. of compartments Size.1.7..__ X y X Liquid depth <br />Distance from nearest welIJO t-) Distance from foundation.. 10 <br />Number-of lines <br />Type of filter -materiel <br />Distance to nearest well.. <br />Number of pits - <br />Distance from nearest well Distance from foundation Lining material <br />Size: Diameter Depth Liquid Capacity • gals. <br />Distance from nearest well Distance from nearest building <br />Distance to nearest lot line <br />s ance f rom neare.s we <br /> Length of each line <br />Depth of filter material....../. <br />Width of trench 2-4, <br /> Total length 00 <br /> Distance from foundation Distance to nearest lot line <br />Lining material Size: Diameter Depth <br />.3 9 CaP'acity../6 C7 0 ''"s% <br />Distance to neare Ii st lot line <br />Remodeling and/or repairing (describe) <br />I hereby certify that I have prepared this application and that the work will be done in accordande with San Joaquin County <br />ordinances, State laws, and rules and r gulations of the San Joaquin Local Health District. I <br />(Signed). .... ......... (Owner arid/or Contractor) <br />- 16, ••••• 111,- <br />By: <br />(Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side).