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FOR QFFICE USE: f ..---., - .-- --.-. .APPLICATION FOR, SANITATION PERMIT Permit No. _ /-�._... ' 3--•--------------- ----------------------------- (Coinple+e in Duplicate) Date Issued This Permit Expires 1 Year From Date Issued Application is hereby made to the San Joaquin'Lonl-Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. Linden ` Ter -e JS; 4g bF47 Lot # 3:4 JOB ADDRESS AND LOCATION =' ----- - Owner's Name---jjO }}'}n --------------------- ------------- Phone----HO_-s33MQ.9.-------- ----•----------=--------------------- -------- -------------------------- iAddress------939---16=eTlga...Rd*---------------------------------------------------------------•-------------•-•--------•--•-------------------------------------------------------------------- Contractor's Name ------ Phone---------•-•----•----------- Nomel:lzui---Conatruct on--------------- Installation will serve: Residence KI -Apartment House ❑ Commercial ❑ Trailer Court {] Motel ❑ Other [_1 Number of living units. __ -__ Number of bedrooms --3--- Number of baths 1--.-_ Lot size 75 Number ---------------------------------- t Water Supply: Pub€ic system ❑ Communify system"9 Private ❑ Depth to Water Table -------- if. Character of soil to a depth of 3 fee+: Sand E] Gravel [-] Sandy Loam Clay Loam E] Clay E] Adobe &D Hardpan E]Previous Application Made: (If yes,date---------- :..... .I No [� New Construction: Yes X No ❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 204 feet.) i Septic Tank: Distance from nearest well__50----------Distance from foundation--10------------Material---Red-44)-p-d_------_..__._..-_--_. f7 p 4x q depth--4ft, -------- Capacity,.120Cgs..1,. t Disposal Field: Distance from nearest well-----------------Distance from foundation.-_.-- No. of cora artments..___.-.__�_-________Size__._ �_��.__.__.__.. _Li Liquid p ..............Distance to nearest lot line_-___-____--_____ {] Number of lines`_2______________________________Length of each line--_60f t•_--_-___--_--Width of trench_2 -0--- - T f Type of filter m terialROCk t- --- Depthofiltermaera __ ______ oaeng __"� ._____--f 4 Seepage Pit: Distance to nearest well-_ {{�� Distance from foundation_-}0 ft-----_.Distance to nearest lot line----------------- �n1� Number of pits--- ming material-- Size: Diameter. �.II�._..____Depth--25f Cesspool: Distance from nearest well-------------__Distance from foundation---------------.--- Lining material --..-...__.--_.____.-________-___. ❑ Size: Diameter- I----------------------------------Depth----=-.---------------------------------------------Liquid Capacity-.------------------- ------gals. Privy: Distance from nearest well---------------------------._---------` :_Distance from nearest bui{ding------------------------.-_--------- - ❑ Distance to nearest lot line......._____._.____.._._____.._ .. t Remodeling and/or repairing (describe):--------- -------------------------------------•--------------------•-------------------- ------------------------4-------------------------------- r------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- tL- r I -------------------------------------------------------------)----------------------------------------------------------------------------•-----------------------------------------•------------------------------------ ---------------------------- . I I hereby certify that 1 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 Local Health Disfricf. (Signed)-------_------------------ --------- ' --- ----------(Owner and/or onfract'or) [ � t By=-------- --------- --------------------------------(Title)----------------------------------- ------ - - -- - - -------- l (Plot plan, showing size of lot, location of system in rela n to wells, buildings, etc., can be placed on reverse side. t FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-------- ------- C't�. '-- "--------------------------- �`� .---------- --- -- --- DATE-----�----- ------� ----- - --- REVIEWED BY--- BY--------- - -------------------- ---------------------------- DATE----- ------------------------------------------------------ BUILDING -- -------------------------------------------------- BUILDING PERMIT ISSUED-------------F------------------------ 1---------------- DATE'------------------------------ Al+era#ions and/or recommendations:..-___..."_i ll.____ __ r �-------� -4--- ._ =-`-s---'- --------------_----- ---•---------- a-�t ------- ---- -`�_ �{ ------------ -�- ---------- -97--- ------------- ---------- C ----- � t- r " ------- ----------------- / ---------- -------------- -----' t FINAL INSPECTION BY:- ------- Date...... ( --------- SAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazelton Ave. 300 West oak Street 124 Sycamore Street 205 West 91h Street Stockton,California Lodi,California Manteca,California Tracy,California