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APPLICATION FOR SANITATION PERMIT Permit No. <br /> `--m,-' - Duplicate)- <br /> Date |mme6 ---- <br /> Applica-l-ion is hereby made to <br /> a Sun Joaquin Local Health D|stric+ for u pnnni+ to construct and install the work herein �ecr6ad. <br /> This applicationJ plwith County Ordinance No. 549. Is <br /> JOB ADDRESS AND LOCATION- Ailor---4-1---M�44-1-W---W-Me----;+0---- <br /> Installation will serve: Residence EX Apartment Ho6se [I Commercial 0 Trailer Court 0. ' 'Motel 0 Other <br /> . .,...�~-. .. .,..� ....^. -/..- .,...~~ of ~.......� -�,.. .,...~~. of baths �.�- ^.. size, /40--- -- _- <br /> ~ -��. - . ..' ~ <br /> W� �p : Public system Community system Private0 Depth � WaterTa6|o.. ft. <br /> Character ofsoil toadepth of 3 feet: Sand E] Gravel E]' Sandy Loam [] Clay Loam E] Clay El AdobeK Hardpan <br /> Previous K�u6n; Ya� [� No New Construction: Yes E] No E]`---- �� ��' ���m�»7 <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> ' <br /> (No septic tank mrcesspool permitted if public sewer isavailable within 200foat} <br /> Distance from nearest wu|L'_---.D|stunco from foundation---------'_-Material ---------_------ <br /> No. ofcomp*rtmonf,--------------------------Size--------------------------------Liquid <br /> Jo�h--_---.--.Capu�+y-_-- <br /> -----'' <br /> D' | � ," Di�n� �omn��� �U ' Di�n� �nm1�n�tion Di�mm � n�n� � |im�---- <br /> ------------ <br /> Number <br /> of |in��'--''-__�'''-'-L�no+ of line------------------------------ oftrench -'''_-_-'-'-'- <br /> T,pe of filter material-------------------------Depth of filter material -_--._Jotu| length'_._-_--_-___- <br /> �� ~~- <br /> 3eeooge PK: Distance well-67Distance to nearest lot S jo-77 <br /> Number nfpi�-��---.-Uning -'S�e: [ iomn+nc."����.-.--..-Deofh-��57�-_---- <br /> ~ � � <br /> Cesspool: D�tonce �omneurns woL'''---D�tuncefrom fnvndat�n_-_'-_Un�gmoter�L--''-'-''�--'_ u�� <br /> F-1 Size: Diameter -_----------- --- ----Deo+ ------------------ -------------- Capacity----------------------------gals. <br /> Privy: Distance from nearest well _'-'''-''-''-'''--Distance from neunns-f-6uV6inq-_'-'''-'_-'-'-._ Od . <br /> [] Distance +nnearest lot line--'� ---------------- ---------------------------------------------------------------------------------------------------------------- ww <br /> � <br /> Remodeling and/or repairing (6nucribe):--------- ----------------------------------------------------------------------------------------------------------------------------------------------- <br /> -----__._-.__...__._-_-.__.----.-.-_--....^-L---------------------------------------------------------------------------------------------------------------------- <br /> � . <br /> -------__.__.--___-__.''--_,-__-__-.-�--'_-.___----__--_.----------------------------.------.-------------------------------------- <br /> '-''-'-------''''---'--'--'--'---'------''''---------'--''-'--'--'''-'----------------- <br /> I h eby certif that I have prepared this application and that fhe work-will-| e done in accordance with San Joaquin County <br /> �ordinances, of the San Joaquin Local Health District. <br /> . � - <br /> .~���'������������ ��� . IContractor) <br /> Bv�.___-__..--.-_.----_. -. ��-.---- <br /> /� ��, � � � �� � �� � �� � ���L6����� � � p�� � �� �� <br /> . .�� ~ � - - <br /> FOR DEPARTMENT USE ONLY <br /> AKm,a�vnsand/or recommon6at�ns:_--_-_--.--_--- -------------------------------------------------------------------------------------------------------------- - ~ <br /> ------''--''''---'---''--'''--'--''''-'''--'--'''---''---'--'''------'---''''--'--------'--- <br /> ------------------------------------_-_-._---------_--_--_--__-'_--_--_-.--._-_-_-_---___--. <br /> '-'--'---'''''--''-'''---''''-'''-''''-'--'''--'''---'---''--'----'--''-----'--'--'-'---'--''--- <br /> ______________�_______________________________________________________________�___________ <br /> � / <br /> FINAL INSPECTION BY�-�./���...-�������--�__.-__- Do��--_�.��-»-�-------- ------ -------.---_.--' <br /> ' - SAJNJOA/QU|NLOCALHEALTH0STRkCT <br /> /»o South m"°,ic*^ Street 300 West Oak sf,=+ mx Sycamore strww* uw North "C" Street <br /> Stockton, California Lodi, California Manteca, California Tm"» California <br /> ES-9-2M ; � n°"a°a vv'x/on <br />