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Permit No. J�i --- -- --� FOR SANITATION PERMIT Issued ----- --- ------ (9omplefe in Duplicate) Date r rib Id. Local H4th-District for a permit to construct and install the the work herein de c Applical-ion is hereby made to the San Joaquin Lo Ordinance No. 549. This application is made in compliance with County ------------------- ------------------- 61� ! `- �� -- --------- JOB ADDRESS AND LOCATION- ----------- ------ ............................. Phone.#1 _14b-- ----- ------ ------------......... ----------------- . -------------I------ Owner's Name------------- ------------ ---------------------------------------------------- Address-----------------------d--------------U_a4s---- ----------- --- ----------------------a--------------------- ------------ Phone--t.------------- Contractor's t.-------------Contractor's Name________________ ___ Motel ❑ Other [:1 House El Commercial [3 Trailer Court 0 Installation will serve: Residence Eriiiii"ii'Xparfrnent baths j---- Lot size ------------------------------- Number of b Number of livini units: ___I-_.Number of bedrooms -- system 0 Private [] Depth to Water Table ----- it. Water Supply- public system Sandy Loam 0 Clay.Loam [I. Clay [y`ALdc;beEIi- El 'et ❑ Character of soil to a depth of 3 feet: Sand 0 Gravel us Application Made: Yes ❑' No [Ai Construction: Yes Previous OF INSTALLATION AND .SPECIFICATIONS: al TYPE I L permitted if public sewer is available within 200 feet.) I ----------- - (No septic fankL or cesspool —-- ------ ------ -e from foundation---- Mate rial--e-t.4 - ------------ apa�ity__2 -------- Septic Tank- Distance from nearest weilo Distance id depth- C __IAt of compartments. _-1;1"111--- ----------Size. 1X_Z------------..Liquid No. Distance from foundafion/.(>'t ---Distance f nearest lot llne6------------ ----------- 0 j I.nearest weh1h,�--- Width of. tren,h �_,----------------------- Disposal Field: Distance from ------ 0- --------Length of each ]ird ine,_3-------- ----- -- length.107— Number of I ------- Depth of filter material ---------- -Total le2q. -- ;�4/ a-- Type of filter lmaterial_�� .......__..Distance to nearest lot line--------;-I-------- a - - -----Distance from foundation I--------- 'e to nearest well------------ Depth----Pit: —bist C ------------1 ----Lining material-----------------------Size: Diameter--------------- J El Number of pits--- --------!--------- Distance.from nearest wel[-----------------D'stance from foundation----- -------------Lining material------------------- 11 iis.--" Cesspool: -----------------Deptin- --------------------------------------- ----------Liquid Capacity_-------------------------gals:"-` Size: Diameter--------- ----------- buil in - ill 11 Distance from nearest bu ng------------------------------------- Privy: Distance from nearest well------------------------------------------------ .. I . I-----------------------------------il---------- Distance to nearest lot'line-----------:------ --------- ----------------- --------------------------i I I N ---------------------------- ---------- Remodeling and/or' repairing [clescr;be):----------- - ------------------- ------------------------------- - --------------------------------•------------ ------------------ ---------------------- -------------------------------------------------------------------------------------------- ------------------------- ---------�_y-------------------------------------------Lr----- --------------------------------------------------------------------------- .1 -------------------------------------------------__.L:---------- - ------------------------------------------------------- --------------------------------- ----------------- --------------------------r n accordance with San.Joaquin ounty - ---------- - -----------------------------------------------------a-_p-repar-e-d-_this application and that the work will be done it I hereby�certify that I havi I Health District. State laws, and rules. and regulatt ns of the San Joaquin Local I ordinances, PP I wner and/or Contractor] (0 ------------------------------------------ -------------------------- Signed ---------------- ---- ---------------------------------- ----------------------------- ------ -- ---( -(Tite)----------------------------- - d ------------- ----- of lot. location of system in relafion to wells, buildings, etc., can be s.iel.placed an reverse (plot -plan, showing size FOR DEPARTMENT USE ONLY - - ---------------------------------------------------- ........... ... DATE------------e- APPLICATION ACCEPTED BY--------- ---v--- DATE-1_ I--------- -------------------------A.---.--------------------------- - - ..---.... REVIEWEDBY----- -------------------- -------------------- ----------------------- - --- ------I---------- -------------------- 43 BUILDING PERMIT ISSUED-------------------------- ----- ------------------------ -- 1------------------1------- -_------------------- - Alterations and/or recommendations—.:-----i ------------------------------I- ---------------------------------------------------- ------------------- --_ -- -------------------------------------------------------------- --------------------------------------I-------------------------------------------------------------------------- - ---------------- ----- -------------------------- - ------------- ----------------------I--------------------------------------------------:-_--.-.-.-.- .. ----------- ------------------- ----------------- ----------------------------------- - --------------- ------ I --- ------ ----------- ..-.----- -- -- --------------- ------------- ---- ------------------------- FINAL INSPECTION BY-------- ----- -- ---- - -- SAN JOAQUIN LOCAL HEALTH DISTRICT 814 North "C" Street 132 sycamore Street 300 West Oak Street Tracy, California 130 South American Street Manteca, California Stockton, California Lodi, California FS-9-21`1 145446 ATWOOD 12_s4