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r Folz OFFICE usE: :I p�r / ct' 3 ---------------- --------------------------------------- APPLICATION FOR SANITATION PERMIT Permit No. ..7�.. .�... I ---------------------------------------• ------------ 5 ---------------------- �- (Complete in Duplicate) ..............-----_-.--.---.---.-_------.---------.-I;- This Permit Expires t Year From Date Issued ' Date Issued .... Application is hereby made to the San Joaquin Local Health District for a permit to construct and instal the work herein descri ed. This application is made in compliance with CountyOrdinance No 49. PP P Ha mar Heights -� Sool stofn"M"of St lhoLathrop..- l._---.• ' JOB ADDRESS AND LOCATION-------•---�------------- ig-------..... .-.............. ............. � r, Owner's Name-----_.Phi.11 �l�..C 4>kS.�r..,...G- -..................(& - N s .... Phone._HO 2'..Q� 864 W, 5th St. a Address............................... :..---•------------------------------------------------------------------------------------------------------------------- The DAY & NIGHT SE he DAY & NIGHT Septic Tank Svc. --- Phone...40_..6- ��!..... -- ••-------•------------------------ -------------..-..._------------------------- ------ Installation will serve: Resid nce n Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living iunts:)_-I.. Number of bedrooms.'_-_ Number of baths ---I- Lot size __- .........................:.. Water Supply: Public system X1 Community system ❑ Private ❑ Depth to Water Table -------- ft. Character of soil to a depth of 3 feet: Sand ❑` Gravel ❑ Sandy LoamIZ Clay Loam ❑ Clay ❑ Adobe❑ Hardpan ❑ j Previous Application Made: {If yes,date--------------------) No ❑ New Construction: Yes Z[ No ❑ FHA/VA: Yes ❑ No ❑ i 31. TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) SRptic Tank: Distance from nearest well_.-.ane Dista ce fro foundation CC Br c —= WY:� . .. .: .- x _ - .,� ._�.,_ 00-------------- 1: aff _ . No. of compartments----------- --- Siie� re- n'.... - Lrgwd d ith 8- 'lC-apacitY ... P from nearest we€I--_-.N0M_Distance from foundation.......10-t_-_�- D'�t�ante to nearest lot line ..... -Gal- Disposal osal Field: Distance from'lines------- ------------------------Length of each line---- ._` 'Width of trench....2411 14 Type of filter materiaAU-s,----Rke__Depth of filter material__--- 8__-___-----.Total length___. ..... 0 1 *' Seepage Pit: Distance to nearest'well----------------------Distance from foundation................•_..Distance to nearest lot line----_-_...__-...- Number of pits----------------------Lining°material------------------------Size: Diameter--------:-------------.Depth-------...._.------_-•--------- � Distance from foundation nearest well_________________ -----------.--.----.Lining material-------------- Cesspool: Distance-:from .-__. [] Size: Daimeter.---- = ------------- --De th--------------------...•----------------•-----------Liquid Capacity gals. Privy: Distance4rom nearest well--------------`--------.------------------------Distance from nearest building-------------------............--.--- ' ❑ Distance'to nearest lot line------------- ---•____---_.-_---- ' Remodeling and/or repairing (describe) `�= =� -------------------- ......... -------------- - —------------- ----- ----- _---�1►45 J ��FSTIoN- Q TR1� rT X19!D r :I�ll!0tk1,: C#F. 'C. -...RAI-5;�------/A(ME "� .sf_0LrT-- . i . '_�- --------- -------------------------------------------------------------------------------------------------- --•------------------------- T! I hereby certify that (',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 ocal ealth District. The DAY &# NIGHT.Sept c�T.ank 'Se'�r e ' - ------------------_----------- � Contractor) [Signed}..-......-- . ' B " --------------------•---- ttle)...... --f--------- —(Plot plan, showing_size of lot, location of system in relation to wells, Idings,.etc.,. n be placed on reverse side). FOR DEPARTMENT OtE ONLY APPLICATION ACCEPTED 1. BY------------------------------- ---'-----------------------��1--� ..- DATE------.-�=-�.`".�-_�_y-=---------•.... REVIEWED BY--------------------------------------------- _.. DATE-------• .... BUILDING PERMIT ISSUED-II--.-----;•------•-----------------------•--- `---------------------------------- - -- •-• rDATE. - - - ------ Alterations and/or recommend'ations-----------------•---------------------------------••-----------------••-•---- - - •- - ----- - ----•-•----------.._...---------------•---------------------------.. II ------------------------------------------------- ...........................................--------------------------•---------------------------------------............................................................. .. t .--------------------------------...... ..........---- -------- ---------•------------ �h--- ---- --- . •----------- ---- t- FINAL INSP Date--.---- - .--_.�JJ E SAN JOAQUIN LOCAL HEALTH DISTRICT iI 130 South American Street II 300 West Oak Street 114 Sycamore Street 205 Wert 9th Street Stockton,California Lodi,California Manteca,California Tracy,California E8 9 REVISED e•99 ZM 5-61 ATLAS I� - Q