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FOR OFFICE USE; <br /> Applica-fion is hereby made to the San�Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. jr- - /dO- 2-7 <br /> ADDRESS AND LOCATION--- -A)w <br /> Owner's -----P <br /> Installation will serve: Residence �parfmenf House E] Commercial E] Trailer Court [I Motel Other E] <br /> Water Supply: Public system E] Community system E] Private'---I Depth to Water Table 3�-ff. <br /> Character of soil to a depth of 3 feet: Sand [] Gravel E] Sandy Loam E] Clay Loam E] Clay F] Adobe NZ Hardpan <br /> Previous Application Made: (if yes,date----------- No New Construction: Yes No A FHA/VA; Yes D No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Disposal Field: Di�fance from nearest well...5b---------Distance from foundation----�P-4?-------Distance to near est <br /> Remodelimg and/n, ,epn�r;ng (6eazibe):'-''`-'--_��.'-'-,---''__'--_--_._________________.__.____________ <br /> . � ----_-_--_---.--.-'-----'-_-_-.—' <br /> --'--'—''--'--'----'-'''-''--'---'''''--'---'----------------------- <br /> ` <br /> ___-_---._-.__--_----^—_------..____--_---___--'--__.-_-__—___.__.--''-''-''�_ <br /> - ---------------------------------------------------------------------------------------- -------------------------------------------------- ,--------------------------- --------------------- ---------...... <br /> — <br /> have prepared this application andthat the work will be done in accordance with San Joaquin County <br /> 0 er [i nd les and regulations of the San Joaquin Local Health District. <br /> . . - <br /> ` ___.____ }�HwL-------.--__ - ----'- <br /> . . showing size of lot, location of system in relation fm °ells. buildings, etc., can be placed on reverse side). <br /> , <br /> FOR DEPARTMENT USE ONLY, <br /> --------------- <br /> _-----''--'-'_-_''-''-'''_'__�-'--_'-''''_-_'�_''---'-_''''--.-''_-''-''-_''_'''---''--''-,-''' <br /> . -''-''_-'--_--'--''--'''-_'----'-----.'--'" <br /> --''-'-_'--.-'--.--^''-'_'-------'''-'---'-- <br /> ------------- ------------------------ -.---'''--'- ------- --------------------------- ''__''--''-''------------------------------------------ -------------- '�'-''-' <br /> . <br /> �N/\L |N�PECT|{�N QY�----�_-- --- Dut�_-_~_..�{_ �7 -�_���._____.____ <br /> SAN JOAQUkNLOCAL HEALTH DISTRICT <br /> 1wo1s.wmzolmnAve. xouWest Oak Street 124Sycamore Street moWest 9th Street <br /> / <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> \ s� ° *mv.�"" o's� ," =*� ��u�� ' <br /> ` � <br /> ^ <br /> � <br />