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N FOR SANITATION PERMIT Permit No. .- �.-`T ` G� APPLICATION y� (Complete in Duplicate) Date Issued This Permit Expires I Year From Date Issued Applica}ion is hereby made to the San Joaquin Local Heal$ 'District fpPa permit to construct and install the work herein described. This application is made in compliance wytf oun Orli' GeeNo`` 5449 P' JOB ADDRESS AND LOCATIO _--- - - - J •- •--------------- -- - ---- ---------- --------- - ------- - --------- Phone--- - ------------------------ Owners Name------------- -- - - - i ` ?? '_ �-------------•------------------------------•------------------------------------••------- -... -------.-------------- Address--------------- a• Contractor's Name - - -- --- -- ----•----- Phone. P Commercial Trailer Court ❑ Motel ❑ ,Other ❑ Installation will serve: Residence �Apartmet House ❑ T1-1 railer Court ---------•-------------- Number of living units: __!-- Number of bedrooms -.- Nurriber of baths -_ .-- Lot size _-._ --_ ---. i Water Supply: Public systemCommunity aystem ElPrivate ❑ Depth to Water Table - ._�` ft. Character of soil to a depth of -feet: Sand ❑ Gravel F1Sandy Loam ❑ Clay Loam ❑ Clay El Adobe®�fardpan ❑ Previous Application Made: Yes No Ne,Construction: Yes'' o E] FHA/VA: Yes 91---No El' ❑ M . a j TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well-----------------Distance from foundation--.f---_-.-----.Mater]1---C11- - - � � - aO, No. of compartments-__-t�------ ---- ---Size-��'--q--t ------Liqu deP.}h Q,---- Capacity r � ...Distance from foundation_-ZO-------.�j'�t rice to nearest lot lin�� _----�- Disposal Field: Distance from nearest w 1/ ,t�, i� f�,'.of trench:_- - ---------- -------- Disposal of lines------ y------"'-----Length of''eacli he- _-_ f� + Type of filter material--1-- -- �G= Dept$iof filter material--- ----- ota� length----f ------ A \ ` y P � -41, � i `S Seepage Pit: Distance to nearestell-----__--�"--.----Distance from f6bndatian_-_..__. __ Dist�/e to nearest lot line U;-, Number of pits----- -------------Lining material-.� ..�Y% Q�`` ` 'Size: Diameter.:_ . -_ :._--.----"De th .�+----- ----- - ---, --------------------- - Cesspool: Distance from nearest well----------------Distance from foundation-------------------.Lining material------..-.-.- 9a15- . Depth----------------------------------------------------Liquid Capacity-------------------------- Pri Size: Diameter-------------------------------------- ' _ �_------ Distance from nearest building------------------------------------------ 1 Privy: Distance from nearest well_ a ❑ Distance to nearest lot line=----------------------------------------f---------------------- - - __J - Remodeling and/or repairing (descrsbe):-----------'------ - 1 ---- ------ ----------------- ---- ---------------•----•--•--------------------------------------------------- ' Sa ---------- ---------------------------------------- I herebstate flawsh anI have a Pre ad this s Ili the San Joaquin+h work cal Heawill lth Disdone �etn accordance wit h San Joaquin County ordinances. regulations -------- ----- (Signed) �a r Contra (Signed)_ - -'��/ Ya+o �! 1 f Contractor) -. woer' or / By:-------------------------------------- --_--------- ' = } (Plot plan, showing size of lot, location of tem in relation wells, buildings, etc., can be'placed on reverse side. FOR DEPARTMENT USE ONLY --- -------------- -- DATE--------1�-`-I-'- ----- ------------ ---- APPLICATION ACCEPTED BY--"--------�,-F-'0 -------------------------- DATE------- ----------------- - -------------------------- REVIEWEDBY-------------------------------------------------------- --------- --------------- ------------------ -.-- DATE--------- ------------------------ BUILDING PERMIT ISSUED--------------------------------------------------------------•----- - ---------------------- - Alterations and/or recommendations:-------------------------------------- ---- ---- - ----------------------------- ----------------------------------- --------------------------------------•--- ---------------- ---------------------..---- -- --------- ----------------------- ----------------•---•--------------- --- ---------------------------------------- ------------- 1 --------- ---------------------------------- ----- --- --- ----------- ----------------------------------------------------- i ------------------------- --------------------------------- x;:, INSPECTIOf�.BY ii i Date F-�------r�--- • FINAL =- - --- ------- - ----- - - SAN JOAQUIN LOCAL HEALTH DISTRICT Y 132 S, m caore Street 814 North "C" Streat 130 South American Street 300 West Oak Streot Tracy, California Stockton, California Lodi, California �`}� Mariteed; California ES-9-2M Revised 6-'59 F.P.Ca.