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� . FOP,h�� SANITATION PERMIT Permit r o+a |o�e6 '(Complete in wu��"`� [)This Permit Expires Iearrom - | U work herein descr1med. Application is hereby made to the San Joaquin Local Health District for a per t ' This application is made in compliance with County Ordinance No. 549. i ~ ' Contractor's Name__-_- -_----- Installation will serve: Residence 2-'Apartment House 0 Commercial [] Trailer Court E] Other El le�� 0r- � .---Num6e, of \i�ng units: Number of bedrooms �3.. Number of baths ' Lo+ size -' � ,_--- ��,�4it' f�U Depth Wafer Supply: �6 / /i �� �� o� to depth�� 3 feet: Sand [:] Gravel D Sandy Loam Clay Loam Clay E] /�o� � Hardpan � P,o°;ows Application kxa6e;'Yos Ej No g�- Now Construction: Yes [��No D FHA/VA. Yes E] MoQj~-- . TYPE �]F |NSTALLAT|C)N /�ND SPECIFICATIONS: ^ (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic T nk: Distance'.from nearest weh-W.49I)i5tance from foundation-.--- Materia�-------------- \ --'-a istance from nearest weh.^1AF-_.D'!stance f,�m founclation--j.0------------Distance to nearest lot line_S�_ ------ � uo Number of |inas--- �^ � �~- nn/n-k-------.Yi6th of trench-..4�. ` ------. Type of ��or motorioL~O--'-ue�t�_�f G|h,r mo+e,io| ~r-0='----Tot | length �� q-�----.--.. ^ ~ � X_ Seepage pit: Distance to neureotw=L-'_---''Distunce from foundation-------------- --Distonceto nearest lot line----'-'-- 8�~ [] Number ofpits----------------------Linin�-mofe"ia|-----------_-'��o� Oiomo+ec-_��----u�p��---'--r..~_._. ~" Cesspool: Distance from nearesf�w-ell -----------------Distance from, foundeCon--------- ----------Lining material r� ^ ~ , ^ ^ -- ---------------- Privy: Distance from nem,00 well ~'-''-''-.'--- ' Distance from ^=~'~^' building-------------------------- El -'- E] Distance to nearest lot line�—''- -----------------------------------_-'---_.__'---__'`'-''__'-'___'____'___ ` � / � -L��. | R�mod�ingond/or �poiri"g (6a�rb��---'_--�--''-'''��_-'-__'-__-_.__' ^ _____.____�__________ . ` . � ' ''-'-'_-'�'��''-'_-'--'-'-'-'---.- -----'--'----'�'-------'-------'�'-----------------------------------------��' ` '-''__________________------'L_-_-r''�-------------- -------'' -''--''---'��''-'--'-'---''--�''-- � -�-� -,----------------------------------- -------------- ''-'�-'----__--'''--'-''-'--' -�� -_- - -_.'---''_-' ''-_-' I hereby certify that I have prepared this applicationand that the workwill be done in accor-dance w Hbalth District. 1 -4 ' ordinances,° ~'~'~ laws, -�' --- -- '-"--ons of the San Joaquin ---r_.� ---------------------------------------. ' ��_m m9 � (Sign ed)-__917L, ------------------ B'« _---.'''_--'--''---'--'-.''''-''�--_'-_�'---'''--�.. e -'- ----------- \�—�--�-�-~—~-- g ,��t o��n. showing size of lot, location � system �-�� s� uu/mm � mtc.. can be placed on reverse side). - FOR DEPART KxEN| USE ONLY � APPLICATION ACCEPTED BY D/��' REY|E\YB} BY---'_—.--_---- ---'---'-,-��-'--- ~'^^ 8U|UJ|N(� PERMIT ISSUED..-----_' '------'---''--''---'�-- DATE---f-'�-''''-'-''--''--'- | AKeruGonoand/or recnmmen6a�nns:-----.]�------------_.-_-----.-_-'--�-.------.---.------.-..----' f .----'_._—_--'----'------------------'--------------'------------'---' --''--'''--'--^'--'----'--'-''-'--'-'--- -----------------------------' —' --'_---� �__�_�_��_��___��___�_��_�_�__�_�� ��__�� '� —� /7 | Date-- ��-'�i��`, ' F|N/\L |N�PECT|(� ---.^-. ----------------. LO��ALHEALTH O\�R�T ��N ��0N m+ w �� "C" Street 130 SouthA�°�" Street 3� `� � Street. 132 ��= Street 814 sm"eon. California Lodi, California Manteca, California nam^ o"li6,rn/* o."-oa m~�=a6-,/ Fpm. ^ ' '