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� /° <br /> ' �� �� -1 <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br /> (Complete in Duplicate) Du�n Issued ..� <br /> . <br /> - , '_ .°� ~ -_~_- .�~' '�_ '` -�_'' - '-' <br /> ' T~ ~` ' ~ � ` ' ' i J | d�U +6� � h ` i 6 �6ad <br /> This application is made in compliance L49 <br /> JOB XDDRESS ANDj LOCATION1400 ---------------- <br /> ' Addne - <br /> Co tn,ct& Name_ <br /> --all4 -k-P—Iltment House- E] Commercial F] Trailer Court E] Motel [D Other E] <br /> ' 't 3Number of /--'- � <br /> Number of living units: Number of bedroom <br /> Character of soil to a depth of 3 feet: Sand El Gravel El Sandy Loam El Clay Loa <br /> � pm°i�un ��pxwa�/*n ,wa�w; /�,��� now�r� ``e° Construction: ...&--.- ^]TYPE OF INSTALLATION AND SPECIFICAT16NS: <br /> � <br /> (No septic tank or cesspopeAr�ii-led if public sewer is available within / <br /> Septic Tank: Distance from nearest well-----------------Distance from foundation,--- ----------Material_ <br /> Disposal Field: Distante from,n6aresf well-----------------D�stance from founclafionj_or_<�----Distance-to nearest.of line <br /> Type ---------- <br /> y of *|+emater i /_ �� Depth of filter r-6,aferial----- --'_.--Total' <br /> ' +- ~~_' <br /> *= ~= page Pit: <br /> Didn *u � �v/ ' uur nnvrom <br /> IN <br /> ' e <br /> ------------ <br /> I hereby certify that I have prepared fhis-'applica+ion and that the work will--be done in-accorda ce with San Joaquin County <br /> ordinances, S a laws-: and rules ;and 4r-g-ulaflons. of the'San Joaquin Local ealth District.'i <br /> ' ( <br /> ' —(Plot plan, showing siie �of I �fsyifern in "dlaifion to wells, buildings, efc., can 6o placed side).. f ~' <br /> FOR DEPARTMENT USEONLY <br /> APPLICATION ACCEPTED BY <br /> / BU|LD|NG P8lW|T ISSUED'-,-�'--'-'J��'-='--'---'-'----�''----_'--�':_'�� DATE�'�-'�''-''`__-�'-____�.__ <br /> . . � <br /> A�on��no and/or ____~_�__________------- _------------------------------------------_----------------------_______. <br /> '__'_--_-''-'--_-.''''­-�-_''�`''-''.--'--- -''-_�''-_-_-_'^'_-''-_-��''�---�-_-___--'-----_-�'_-' <br /> ---___-__-__-_'�'�-_._----� ��-.-^----._._---_--_.--_-__-__--__--_----'�—. <br /> ' ---__-'----'---�_' <br /> —'-----''--'-''''�-'--''---'�-'''-'-^-----''----__--------''-'''----_-'--, <br /> . �'-'-''-_'--�' '-''-'_--..�'�-�.------__---_---_-_' <br /> --'''--''--''--'-''---''-_''----'_ ' ' <br /> - -- ��Dn+a '�� �zs�°/== <br /> RN/\L INSPECTION, BY� .----.._--_-� - --. -.� --^---_______. <br /> � <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> mn s"wk American %*re.w 300 West Oak svm° |uc nvoam"m Street 814 North "C' $tr°° <br /> Stockton. California Lodi, California Manteca, California Tracy, California <br /> _ <br />