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_-, <br /> ` <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br /> (Complete in Duplicate) Date Issued _'''/7'�).7. <br /> n <br /> AoUcut|o. in hereby ' o6o to the 3uo Joaquin Local Health0i� � construct <br /> ri�� � o permitfvund |n�aUthe work har�n described.Thi' application is made incompSancewith County Ordinance No. 549. <br /> �� | <br /> JOB ADDRESS AND LOCAT|{}N- ---------------(.0 ADDRESS0� +° ___-_______---- Phona----_--'-'---' | <br /> --------------------------------------------------------------------------------------------------- <br /> - <br /> . <br /> _ _.___. Phone ---- <br /> Conhncfo/s . <br /> Installation will serve: ',� ApartmentApartmentHoHouse0 Commercial [] TrailerTrailerCCourtCourt0 Mofel [I. Other E] � <br /> Number of living unit`:/-------�Number of bedrooms Number of 6nHn /- Lot size <br /> ' �0'119 <br /> 7F---------------------------------------- <br /> Water <br /> -_--._----_--Wate, Suumiy: Public system 0a Community """*-_'[ ~'Priv'a-t�'E]'"Depth to Water Table ft <br /> Character of soil to m depth of 3 , <br /> �� �� [� ��� � Sandy L�. U� Clay Loam [] Clay � /���[] Hardpan [] <br /> Previous ApoU�w��n ��a6e� Yes �� |o Now Construction: Yo` � No [� . Yes [� y4oEj ' <br /> . . <br /> TYPE OF INSTALLATIONAND SPECIFICATIONS: �� <br /> (Nn septic tank or.'coovpwo} permitted if public sewer isavailable within 200 feet.) <br /> Septic <br /> Tank: Distance from noon,ofwell--- Distance -f-u"uocla+inn.AVc'~----------Mo+u,iuL_4� <br /> ---------------------------- <br /> No. <br /> -----. --- <br /> No. of cumpo�men+n,� ��.� . ..�Pe� + �� �� ' qui� �;F . � � � <br /> x k~ _ .�--'_- � � - <br /> Di,r-'n| Reld: Distance from nearest veU. O-._Di,+o. undution./x------Di�onoo to nearest lot line-4 * .-- <br /> ----------- <br /> Number of lines � Long+h of each line-30- .�VldH, o[ +m. `h-_ --------------- <br /> Seepage Pit: Distance to ~e/ -----Distance from foundat;on--/O------------Distance to nearest lot line-s- I--------- <br /> -�� » - o� n.ing m�^� uNum6erofp��� om-!(-'''-Size: ummeter_ w-X "1,"=."Dept.. ~ ---- -------------------- <br /> Cesspool: <br /> -'''-��-Cos000 ` Distance from nearest well '-'--'�-Distance from foundation---------- ---------Lining material -''-�-'_----''_ <br /> ^ Liquid Capacity ' '.gub <br /> El 'Size; D�mef c --- --- p �. - ' <br /> : l <br /> [��onco �om n*or�� � Distancefn�m nearest ��|6ing---_''-'__.-�_- <br />� El Distance to nearest |o+ --------------------------- ------------------------ ------------ -------------------------------- ________�_ <br /> ' v <br /> Romn6e�^g mm6/or repairing h6up�ib�:-----.`_-'.-_-_-___-___-''__.-____-______________________ <br /> ____________.�_.--_-! ------'---'-----'--''--''''--'-----''------''---'- � <br /> ---'----'----'''�''-� �. n __.____._�_____''~^__--''-'-��-'-'-' <br />. .-_-_-_--__-__-_--._--�___�..--'_.-�---_-___'__.- ' <br /> / � _______-__..__.---''-_-'-_-'-_'-_.'_-_---'--'-'-''�' <br /> '------'-cert--ify-th-------------`--' d that the work will be done in accordance with San Joaquin County <br /> hereb <br /> repared this application <br /> ordinances, Sfate)awsl and rules and regulations of-t.he-San Joaquin Local Health District.(Signem)_-~~-- <br /> � OP|ot u|a'` showing size�-'-fi�^. location of <br /> - �system inrelation to */m|ls. 6uUd|ngs, e+o, can be placed on ,mvo,*esma1. ' <br /> FOR DEPARTMENT USE ONLY <br /> | REY|EVVED BY---------------------------------------------- ------------------- ------------- --------------------------------------------- ,".�.________________ <br /> D/��. <br /> BUILDINGPERMIT ISSUED------------------------------------------------------------- .--^___.___________ <br /> Alterations and/or rwc*mmpn6ations:------------------ ------ <br /> ----```````--```----`--``--`--``--------``--``--'``--``--'``------``--``--```--`-``---`--'`-`- <br /> . <br /> --------------------------------------- --------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------- <br /> _________________�_�----_______���________________________'_______________�_____________________' <br /> | ---------------'--'-------------'-'--'----------'------------------' <br /> . ^ <br /> �� <br /> RN/\L INSPECTIONBY� -._--__- "�.=-^..,�_..=__.+__________.____ <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> mo South American Street xonWest Oak Street |az Sycamore Street ow w"*h ^c' &*=m <br /> sm"kto". California Lo6|. Ca|/*,rnia Manteca, California Tracy, California <br /> ES-9-2w ' Pe"/"°" 1'57p-n,co. <br />