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Permit Np <br />---- APPLICATION FOR SANITATION PERMIT` ----,-----' <br />' 87 (Cmmnp�fwim0up|�arw) _ Date Issued '2���11���' <br />---- Date Issued <br />' �� n6 |ns�.0 �ho��, herein �mv�,M�wd <br />Application is hereby made to the S° J LocalHealth District for permit *oouno�u o work . <br />This application is made in compliance with County Ordinance No. 549. <br />JOB ADDRESS.. LDLOCATION ........................... <br />Contractor's Name..; .... .. ....................... ...'T ------- 11 ---------- * -------------- * --------------- <br />Installation will serve: Residence Apartment House 0 Commercial 0 Trailer Court Mot?l [3 Other 0 <br />Water Supply: Public system 171 Community system 0 Private M�ePth to Water Table '37pit. <br />Character of soil to a depth of 3 fee+: Sand F Gravel 0 Sandy Loam El Clay Loam [3 Clay [-] Adobe 13 -Hardpan <br />FHA/VA Yes C] No <br />Previous Application Made: (if yes,,date -------------------- ) No UT� New Construction: Yes EEr-'No 0 <br />TYPE OF INSTALLATION AND SPECIFICATIONS: <br />v-~ septic '-- or cesspool , public sewer is available within 200 feet.) <br />from foundation <br />-��u+oraL------ <br />-..---_ <br />---- <br />' ' ~ Distance from nmu,os+wo|-.--_-.D��nca �_'---_-' <br />*p- No. of �ompur�n�nt�--___--S�e..__-_—__--Uqw�6'�0 .�Cmpad <br />' foundation �� �|�un�a t*n�m,e» ��U�a'��-! <br />Dispaisal_,Fjleld�' Distance from nearest U"�]� Distance from ,�n <br />�. <br />------ <br />I <br />- <br />' line _�� Number of |*e� _-Len9mv�� <br />x�--_/o/u/ �ngr"_-___-.-__-_. <br />Ty of filter materiDepth of 6|+nr material --.~ <br />�*o| u,u `- �o nour�� - <br />Seepagenear^^_ <br />4 - <br />.` /��~^ <br />`. <br />�� <br />All <br />"f p�o./-_--_U Lining material ��� �6�e' D�m��ec�uoprn-' <br />------- <br />Cesspool: Distance fnvm`n�onest'`wnK- -''Dh�oco6om foun6oMon-''''---U�ng mofa�mi''-'-'_-__'--_s' <br />.�D . ..LiquiJ Capacity --------g� <br />S. <br />Size: D|umwte, -------- -- _ <br />' Distance from nearest well --- i -,_--._---------------------------- from nearest building .'-''__-____----' <br />Oistonce to nearest |o+ km��------ :---------------------------------------------------------------------------- <br />'-_ <br />____-.----_-.-_..___._--__---' <br />Remo6o|ng and/or repairing (describe):----- .. --..___...-�_-.__-����������� <br />��������.������'��.���'����'��.'��'��'�.����'��.����'''��'�''�����'����������' <br />... ' __-_-------'---'------- <br />' <br />-_--_-__--__.—_-'',_'-____--'.__--- <br />_ <br />- ` __-__...__'_--___.-'_--__----- <br />ith San Joaquin -County <br />I hereby certify that I have p'rt�pareA,f�is'a-o'p�l't'c�"ation and that the work will be done in accordance wi <br />ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br />- <br />. \�gn��� ' <br />By: -------------------- ------------- -- ---- -- --- ­ ----------- / ------------- 11 ---------------------------------------- (ritle) ---------------------------------------- ---- ------------------ <br />��a'iion o sys�em etc., can be placed on reverse side). <br />� ,_,_' showing <br />size of iot, location ystem in relation to wells, buildings, <br />FOR USE ONLY <br />APPLICATION ACCEPTED QY'c-�. <br />..-'--'--'--'---� J <br />BUILDING PERMIT ISSUED -------------------------------------- <br />Alterations <br />---------------- DATE-.-//) '. � <br />'-_.'-_DATE-'-_-'--_--_.'__'-_---'' <br />�``�`-�'``��'`��'``���- <br />� � <br />'—'-------'—'' <br />---------'-------- <br />'-------'-----.--''-''-_'''-''--'-'---_''--'—_''-_'--.''__'-_.'__-'-'-_'_-.---''-'-----'--' <br />'-'-''---'--'------'''-------'''—'''-''---'-'''---''--''-''---''-'-''--'--'''-''-''-''-''-' <br />/ <br />//) --/-� - /~- <br />F|NAL|NSPECT|{}� BY:-.3,2.)i <br />Y�.� ..�p��+����������------. u=`o-f-��--_'~"--'^._------------ <br />~ <br />SANJOAQUlNLOCAL HEALTH DISTRICT <br />130 South American Street � 000West Oak Street 1o*Sycamore Street z05West p1h Street <br />Stockton, California um/'«an+�,"/* Manteca, California /,m"California <br />^ .. <br />"°'"'""o"*'5pow°'^/ATLAS <br />^--e <br />� ' - <br />