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I I-UK OFFICE USE: ------------ ------ --- APPLICATION FOR SANITATION PER Permit No. :..2.0_.�2,3 (Complete in Duplicate) ------------ ----------------- Expires - —o ._ , Date.Issued This Permit 1 Year From Date Issued f- Application is hereby made to the San Joaquin Local Healfh District for a permit to construct a d install w&A!�scr;bed. This application is d 'n c )ml e with Count Ordinance No. 549. S0--4 � pek �af 7 7 77 Y North of JOB ADDRESS AND LOC. TION? __Rte Boaz 533; S'tocktoni West F on Pd ' ;y�,Y - - --- --- ----- - ---- -•nt - e --------------•age Road off Hi Way ------------------------------------------ 9---3®--- Owner's Name-------------- ---- Bernadine-•Cts_-W.0 'SOA 3� �d Same -` -- - Phone 3'"��Q� Address-----------------�---•--------- - •-.-- -------------------------------- ------------------------------------------ -------------------•--------•-------•------------•-------------------•--------•----------------------•- Contractor's Name-The R•1y_& NTGM' Septic Tank S_e_rvice 466•�38l11 Phone _ Installation will serve: Residence `Apartment House ❑ Commercial ❑ -frailer Court [-] MotelOther El � Number of living units: _.Z._-- Number of bedrooms ---Z- Number of baths 2----- Lot size __.-._._._____ri 7 crew Water Supply; Public system 6D ------ ---------•------------- ---------- PPY; y ❑ Community system ❑ Private A Depth to Wafer Table ___..- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay Adobe EY Hard en 011-� Previous Application Made: (if yes,date____..__.._._------} No ❑ New Construction: Yes ❑ No EF FHA/VA; Yes [] No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: ,c {No septic tank or cesspool permitted if pullic�sewer i�available within 200 f� I �jll — 9�r20T Septic lank: Distance from nearest'well. _..______Dfistance fromoundation-#1 A. _ ----- aterial ncrC No. of compartments=._- % Size_ t � uid depth-561 �- ------ q 2Gt ----------Capacity-----� Gam__0 t+ Disal Field: NumberDistancof Ines yarn st weil------- Dei�tanc from foun��fi on_.,_m_..__ t - (..._...Distance to nearest 1gf jinne--- ----------- �r ept c Rka 4gth of each3 Ime__-_ -- Width of trench..-_ - -.------F JC J Type of filtor mafena -------------_--...._De th of filter material--------------------- '•-x .�.,p j -------- Total length-------------------------------�t: Seepage Pit: Distance to nearesjwell -------------------- ----"-"Distano,%frgm-Ifoundation-�i--_ .: t J y� - ______Distance to nearest It line--------------__ {� Number of pits ---------------- ---Lining material----------- -------- 9. t Cesspool: Distance from nearest w`eIL__.__._.___.__Distan4e from foundation ameter._____________________Deptn_....__--------------------------- ell _..___-._---_____. � . Size: D --_-- Ej - F�I:ining maferial--------------------=------------ -- y r" -- -Depth------------ liquid Capacity -gals. t ---- --- Q p Y Rriv : Distance from"'ize. Diameter- Ill .._. Distance from nearest building--- ...................... ❑ Y Distance to nearest lot line--_--------r-------=------------- nearest we ------I I Remodeling ar�d ,r repairing (describe):.__ --XX Replacing gC� is t %k s stem that has been serving this . S LCX - - I = = ---------- j -----•------------- ----------------- ----------------- over ---------------- ------- ---•--- P. c ._.hauscxha _bex_ 3_ = over--Aaron_.©fin beexi knii� over D-g- �t-em;--- C__ r veway_has---- - ------------}0oa't --of--st tic--tank-• - E P Pamper-tZ-- --beenn---d vra,c�ed--and-- G Sten tem infr cs-On �."""" 3�- -------------------------------------------- I}hereby certify that I have prepared Ais application and that the work will be done in accordance with San Joaquin County ordinances, State laws, end rules-t-anregulafions of the San Joaquin Local Health District. k S; ned The ]EXY 8c NIGHT sept c Tank ervice -g --------------- --------------------- - -- ---------- ., Contractor) -------------------- ------- � . ..� (Plot Ian, showing size f lot, location of s s+em tri: elatran wells buildings tc., can Title)__. ___-._. ___-- -- y - - p g t° _ e placed on rive-r# side). FOR DEPARTMENT USE ONLY I' y e M4 APPLICATION ACCEPTED BY /' " � 4k1 ' DATE �- ----------------------------- REVIEWED BY --------------------------- --)- - ------------- --- ------------` f F� R 0--------------- ---- DATE__ --------------_- - BUILDING PERMIT ISSUED .-- DATE - • ,-S_„e� --------- ------- Alterations and/or recommends+ions ---___�{ _5 .��- �,�,_.----_-�i��`�_,�-.---/��----- -- -s4 =---- ------------------ ----- ---------------------------� ---- ---------------------- ------ � e FINAL INSPECTION BY:------- `"._.` a} ------- e_ . � SAN JOAQUIN LOCAL HEALTH DISTRICT i 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street t Stockton,California LodifC205 West 9th Street alifornia Jy Manteca, California Tracy,California