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' <br /> � <br /> � APPLICATION FOR SANITATION PERMIT Permit No. <br /> , <br /> ^ <br /> (Complete ~ Duplicate) Date Issued ° <br /> Xw­­­`_A�._ <br /> � ' ~ - <br /> Applica+ion is <br /> hereby made to the San Joaquin Local Health Dist ricf for a permit to construct and install the described. <br /> This application is made in compliance with County Ordinance No. 549. 7Y7�Vlj 1 6�67- jqj­0 / <br /> Contractor's N -.----------------_--._----_-- roono---_--'_--- ` <br /> , <br /> Installation will serve: Resicle E] Commercial 0 Trailer C�� � MotelEl� � ' - / ��� <br /> Number of living units: Number of 6oJmmm� .���' Number of 6uHs .�'- Lot ,�o -��'1�� -7^.^-"i==_-----_' <br /> � <br /> . /�� � <br /> Water Supply: Public system [] � Community system 0PrivateJE Depth to Water Table ~"=' H` � <br /> Character of m@ to a _6on� � � ` �� � ��� � Sandy Loam � Clay Loam � ClayClayI[] Adobe Hx���� ' <br /> ' feet: � _rT <br />' <br />. PreviousApplication Made: Yes Fl No JE New Construction:n� Yex pp No [] � <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public *e�e� bm°aUa�w *Rh� 200 feet.) <br /> . ' ^� <br /> Septic Tank: Distance from nearest weU_ --O|stun fromfoundation-/x-.. �� i | ��mU�t��� <br /> �M No. of compartments-- �---------------- ---Liquid clep�h-..-41----------------Capacity-..�00J�.-- <br /> Disrr | Fio|6' <br />� Distance from-nearest` *m'J||� k -/-.D��ance from foun6oti.~. -�^ _~..._ _ .- |-� ^^ ^f~ <br /> -------- <br /> Number � line <br /> s _/ -- -��� � each line------ ��� - W�� � i�n� ��'--_'-� <br /> �|f*, � ��/ �� ------------------­-­-- <br /> Type <br /> -'--Tvoe of uL- - � �-�n~ <br /> SeepagePit Cxstooco to ne'aroo °oL/j�_' -' 6n 1]0�---' nearest |o+ line'n <br /> Num6er of p| Diameter <br /> ' <br /> |!' <br /> ' /y-�'''��ning mof���|. '-S�v� D��n+e,-�^��-�'��Doo+�-'�,�.'.''----' <br /> �r 1 <br /> : Distance from' nearest well '''--''Distance from foundation---------------------Lining material------------------------------------ <br /> ElDiameter,----- --------------------------------Depth-----------------.------------------------ --:-Liquid Capacity----------------------------gals. <br /> Privy: Mst nco fron:ino9,est welL''--'''�-''�--'''-''Distvncv from nearest bmUding '--------'''___'''--' <br /> El Distance to nearest lot line--------,-.'-------___________________.________ ~ <br /> u Y^ ' <br /> Remodeling mm6/o, repairing "'[r;be):-'---''--''---'-----''--__'-'--''''-_'_-'-'--__._-.''''-__-_--' � <br /> ----------------------- '_-_---------------------`--_-__^_---_--_.----.__----__-_----'_-.-__-'---._---.. ~Y <br /> ` <br /> ' --------------------------------------------------------------------------------------------- <br /> ` l <br /> I hereby certify that I have 'repared this application and +hat the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and re;ula'fions of e n Joaquin Local Health District. <br />! <br /> (Plot planshowing size of lot, location of system in relaflon to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> 49 <br />� AKo,mfYonuun6/o, ,eoommendm+iono.-. ����-.��,���1�.... -----.-..------_---''-. <br />� ' ---.` . .. ' . -._---------..__..-^-.--.------.-_--__._----_---'----- <br /> .-_-----�__-..�.. -�--.. - - �� <br />. ._----.-_--._--- - - --------. .- -----'-_.-_----------_-._-_.-.-_--.__-__-- <br /> -''''--'-'''--' --- ---------------------------------------------------- ------------------------------------ -------.''�------------------------------- <br /> ------------------------------'--' _'''-'''_-'' ' - ''' '-'''-'-''-'-- <br /> FINAL |NSPECT|ON ' ''-- Dufe-'''' ��'_'-_'----''-'- ' <br /> _ <br /> � SAN JOAQU|N LOCAL HEALTH D4STR CT / <br /> n <br /> /nn South American Stroof ` mmv�� o° $�°° �zx �v��wm s�** ow mo�h ^c^ StreetU ^ ' � ' <br /> Stockton, California ` Lod;, California Manteca, California Tra"y, California <br /> .=°^°7W0" ^ <br /> ' ^ . <br />