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"_ IOR <br /> ' APPLICATION FOR SANITATION PERMIT Permit No. 11--/. � <br /> � 0w�|��a <br /> (Complete �~ Dmfm Issued <br /> . . »' <br /> Application is hereby made to the San Joaquin Lpou| HmuHh District for a permit to construct and install the work herein described. <br /> This application [smade incompliance with County Ordinance No. 649' <br /> u <br /> ^`^" ,`"°~ESS ,`mu ---'-'- ---------- ''--'-''''''--'.................-- ------------- <br /> � y� - <br /> _ <br /> Owner's m -...._-------_---.-' Phonm---.'-..-.-.'--.-.. <br /> Add . <br /> Installation will serve: Residence 93-`Aparfrnenf 'H,�use'� Coirnmercia'I'd Trailer Court [] Motel [] Other <br /> Water Supply: Public system E] Community system B' Private E] Depth io Wafer Table 'Aelf. <br /> Character of soil to a depth of 3 feet: S6nd E] Gravel [-] Sandy Loam E] Clay Loam [] Clay [3 Adobe,@- Hardpan 0 <br /> Previous Application K4wdm {|fyes,date ------.) No QEr, New Construction: Yes eNo [] FHA/VA. Yes 23- No E3 <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: % <br /> ° ^ | <br /> � o �m� �� � � pmb� �� � m��6� ` <br /> Disposal Field: Distance from nearest well----—--Distance from foundation-_/ 10-f-----Distanc i e to nearest lot line..d <br /> Number of lines.......11Z----------------angth of each line------ Width of trench--- ............. .......... <br /> th <br /> Type of filter material. __-4/ <br /> ' ^ 1.411 . <br /> eepage Pit: Distance to nearest well----- Distance fi�wn fou d f- n <br /> ~.~�'_.. Distance from ....... well-----------------Distance from foundation- .* material^-'''_---------------------- ` <br /> [� <br /> Size. Diameter _-�-'-------�—Dao+ '''---''''''---���������Uou|d quid-Capacity.' _. <br /> Privy: Distance from nearest well--------------------------------------- -------- <br /> .Dis+un � from neuma+ 6uU6ing------------------------------------------ <br /> .'r <br /> `] D�+unonhznearest lot |ine----._--.—_---. - --.__-'__-_-_--. <br /> Ramo6eing <br /> and/or repairing (describe): L- -----------------------------------------------.......... <br /> ...................................................-.-_-----_-----.------__-.---------.°'-----.--.----.----------.-_----. <br /> -__--_-_--__._—_--_---..--.--__-l---_-__.-_-__'--.__.______._.--_L'__-_--____--.. <br /> I herebK cerflify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, +ate aws, and rules and regulations 6f the San Joaquin Local Health District. <br /> �'g~~... -��°�- _p°��`�~ <br /> (Plot plan. showinq size of lot, location of syste ;Eqtation-to w-ells,builclings, etc., can,-6.e placed,l6n reverse Side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED 8Y--------- ---------------- . ------------------------------------- DATE-.3?� -----.. <br /> REYIEWED BY. DATE-_. | <br /> ����ua��� ����n��m: .� - .��-�.�.�� . - � - � <br /> ------------------------- ------------------ -_-__----------------------------------- ----------------------------------------------------------'....... -------------------------- <br /> ------------- <br /> -_-__--------.- . <br /> ----'-''—'-'--'''-'-''---'-''—''-'''--''----'---'''-'--''''--'---'-''----'-'''''---'--'---'--' <br /> _-'___-------.---._---_---.__-_--'_-----__-.__-'_-_._-'___._---___---. <br /> --'-- - - ----'--'''_-'''---------'-- <br /> -� _ /� � <br /> ------- <br /> FINAL INSPECTION Do��---..�-�� ���-��'y� --_-. <br /> JOAQUIN JOA—INLOCAL HEALTH DISTRICT . <br /> v3wSouth American Street 300 Wes0ii0S,resit 4 Al �j \ 124 Sycamore Street xmwWest 9th Street <br /> Stockton,California Lodi,Calif <br /> mia Manteca,California Tracy,California <br /> `" 9 "xwsx" "'"" nm °'°/ ==" <br />