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.................................................. .... <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br /> ............ ..................... ..... .............. <br /> --•-••-. ._.....--••-..._...---- ......... (Cornplefe-in Duplicate) Date Issued Zc..-.:1=47 <br /> IThis Permit Expires I Year From Date Issued <br /> ......................... <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 /> 1 <br /> JOB ADDRESS AN LOCATION-A-0-----CO&JV07�7-­-o <br /> IVI'I--.f----------------MAWTECA.A. <br /> ZZ......................... ......... ..........................­­............... Phorve-------------------------------- <br /> Owner*s 71 ........012T lea.......................Ph__................................. <br /> 9 <br /> Address___A_1__1.Y5­­_S----- _..........me., <br /> Contractor's Name-- ................ ....... ............................................... <br /> .G........... <br /> House C] Commercial 0 Trailer Court C] Motel D Other 0 <br /> Installation vnll serve: Residence 51 Apartment H 0 <br /> ,s Lot size .......+_.......... <br /> Number of living units- -.1---- Number of bedrooms.3... Number of bath <br /> Hardpan Adobe <br /> ommuni em [3 Private 2��Depth to Water Table ft <br /> or <br /> Sys lay C] [] <br /> tW K Gravel 0 Sandy Loam [I Clay Loam ❑ C <br /> Water Supply: Public system 0 C <br /> Character of soil to a de ❑ <br /> pth of 3 feet. Sand <br /> New Construction VA- Yes.K. q0,0 <br /> Previous Application Made: (if yes,date_.................. <br /> _­.- � — --,.; ­ , - ._� 4. <br /> jypS,QFjNsT,� N SPEQIFIICATIONS-:- <br /> .&LATION A, D_ <br /> ac - <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well_... G.._._Distance from founclation.._Z9-......Material_C61VA14,060'­...... <br /> U <br /> No. of compartments...- ___.:_Si2e--- Liquid clepth.....5-n-5.... ...CaPacity...k1-0-0....... <br /> Disposal Field: Distance from nearest well....6 . _.Distance from foundation..../P.........Distance-to,nearest lot line-..-I ...... <br /> I .......Length of each line__. ' t,...... <br /> Number of lines................Z......... _7.67 _Width of trench........Z--------- <br /> IV —T-ype-Of-filter-.meiierialjRO.4K.....Depth of filter material......A7-----------Totail length.. .........../.-:� ............... <br /> I line_:._._____.._.... <br /> Seepage Pit: Dilstatiite,to nearest well......................Distance from foundation.....................Distance to nearest lot <br /> n Number of pits.)...... Lining materiel---- --___ ...... Size: Diameter---._..................Depth_-_'.'..:......................... <br /> . ..... <br /> Cesspool: Distance from nearest well ................Distance from foundation...................Lining material......................................................als. <br /> D Size: Diameter. .. ......... .................. Depth........ .......................................Liquid Capacity.... g <br /> from nearest building..........................I.........�v­ <br /> Privy: Disianbe from nearest well_-----­---------- <br /> 0 Distance-to nearest-lot line.................... ...... ....... ...................................................... ------•-----.-•--- <br /> -----*----------- -------- <br /> I !S.T.jF OES1 K ------Use.=-----W., . ............... <br /> ,;be):---------!�Y <br /> .A177_4 Wff <br /> Remodeling and/or repairing (desci M-.--A -7—:t .............................. <br /> ftj3A4jF_ 45;?V.6A.A.._UAV1-- ---- ----------------------- <br /> ........_---•-----•---------------- --------------------......•••..--•--• <br /> -................. ..0 . .......401- -ItO........................................ <br /> ......... ..................................... ................... <br /> -.-%......................................................................... <br /> •-•-...---•-•--•......................... :..--•----•---•-•---................................................ with County <br /> 1 4 <br /> I hereby certify Wai-11 hbizzilrqp6md-tkit application and that the work will be done in accordance San Joaquin Coun <br /> ordinances, State laws,jan'd--rullesana regulations of the San Joaquin Local Health District. <br /> Contractor],.;- <br /> .............. lnr_ Owner and/ofL <br /> ......................... <br /> By=-------•--------- .... .. ............................ . ...... ....... ... <br /> (plot plan, showing size flot, Sy-s,#-Gm in relation to wells, buildings. etc.. Ja�-be plac.ed on-reverse side). <br /> cf ---­FOR-0EPA-kT$A ENT-USEV <br /> APPLICATION ACCEPT D ---------------------- --------- •::---•................ ........ -167--------------------------- <br /> .......... .. ...........---------------------------------- <br /> REVIEWED BY------------t : -__ <br /> . ....... .................................. ............... DATE_ ---------- ----------------------- <br /> BUILDING PERMIT ISSUED.. ............. <br /> i ................................................................ <br /> Alterations and/or recoWmendatiom:------------------------- ---z_.... ....... ................ .......... --------------- <br /> ............................................................................ ..... .................................................. <br /> ONLY <br /> --------------------------- <br /> ............................. <br /> ................................. <br /> .......... ............ ........... ------------------- <br /> ... ..... . .................. ............................ <br /> .................................. ............. <br /> .................... <br /> ................................................. .... ........... .. .. ........ . <br /> ... ................. .. ---- - -- ........... ............ ................................................................. ......................... <br /> ......... ......................... ............ <br /> 42 <br /> Date.-----•------ --------- <br /> FINAL INSPECTI <br /> SAN JOAOUIN LOCAL HEALTH DISTRICT <br /> 1601 L Haz*lt*n Ave. 300 Wititt Oak stn»t 124 Sycomort Stmef 205 West 91h Street <br /> Lodi.California Manteca,California Tracy,California <br /> Stockton,California <br /> E.H.9 2M 1.67 Vonquard Frew <br />