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� <br /> � <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br /> ^ k�omo�tm &n - <br /> ^--' -----' D�fo |o,ue6 <br /> _- � <br /> ' <br /> Application is 6am,6v mu6o to H`e Sun Joaquin� Local Health D|drict for a permit to construct and install the work herein described. - <br /> This |icution is made in compliance with County Ordinance No. 549 <br /> Installation will serve: Residence Apartment House [-I Commercial Trailer Court Motel E]. Other <br /> Number of living units'- Number of bedrooms --. Number of baths ­4--- Lot size A-C-14-"77"�_1-------------- <br /> Water Supply: Public".S"ystem Community system El' Private E] Depth to Water Table fw ft. <br /> Character of soil to a depth of-3 feet: Sand El Gravel F1 Sandy Loam F] Clay Loam 0 Clay E] Adobe 94"OHardpan E] -i <br /> Previous Application Made: Yes No jj-�New Construction: Yes &"No El FHA/VA: Ye s E] No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> �~ <br /> Septic Tank: Distance from nearest 11 -) ^ ~~'~^ce ~^' '~~^~~''~^ ^^ ' ------------------ <br /> - <br /> Disposal Field: D�sfance from near�st wet-Xi-E.-Distance'from foundation---A------------Distanc6,to ri'earest lot -0------- <br /> Seepage Pit: D�stance to nearest well-----/12C74'Distance from foub d at i�on-­X.07- Q is fan ce to nearest lot Iin`e`-----f.10--- <br /> Number of pits------4Z--------:-Lining material/ --&-Size: Diameter <br /> ".°.""�" ." "=�=^. lot """ - - -..�__._----------. <br /> ! <br /> Remodeling and/or repairing (6e, 6be):- -------- <br /> ---------- ------'------------------------------ <br /> ------------------------------------- �-`-'-----'-----''----'--''----'---''---''-''---''--------''-'---'---'-------'' ' r� <br /> ----.---_._--'_____--..'---__.___-__.__.--_-.__-_-'__.-__.--_`_---.---_--------' » <br /> � <br /> ----------------------_''----''-__-''''__.- -------------------------------------- ----''--''-'''-'''-__.''-_''--'_-'-''''''-'-'-'-_ <br /> | hereby certify that | have prepaied fhis application and that Aevork will be done in accordance with San Joaquin Count <br /> ordinances, State laws, and rules and iegulafions of the San Joaquin Local Health Districf. <br /> � <br /> cl <br /> (Plot plan, showing size of lot, I iion'ofi system in relation to wells, buildings.- etc., can be place on reveA si e). <br /> FOR DEPARTMENT USE ONLY <br /> -------------------------------- <br /> ------------------- <br /> �-'--« '---'--''�--�--_-� <br /> �-'----------------`-- -� <br /> - -------'---'--'-'-------' <br /> ----_-----___--_-----------'__------'_-------- __------' ------------------------------------- `--- ---------------------------------------------------- ---_---___-----------'----------_'--- <br /> -'-__''''_-'-'''-_-'-------.'__-'--'-'-_''-_''--.'---''_-'''-'''''''''--.`_''_-'-'-''--'---''-- <br /> | <br /> -'-�--''-----'_-'_''-/-'�''-?_' ' -''--~0- <br /> ' <br /> -'-''--_��--'---'--'�'--'''�-L-'.''~')�--�_^v <br /> --' <br /> '- -°'�'� ��'R --------------- <br /> FINAL <br /> '--__' <br /> �N \L |NSPECT|ON BY:­ -------. Date--- -.. - --- <br /> 6AN JOAQU|N'LOCAL HEALTH DISTRICT <br /> ^ , \ <br /> /m South America" street ' 300 West Oak Street /32 Sycamore street 814 North "C" Street � <br /> / <br /> sa°,kto". California L"a/. California Manteca, California Tracy, California <br /> . � <br /> ES-9-2M ' m°.;s"" 1'57 r,pzo <br /> - -- <br />