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��� 4� � <br /> .� ' APPLICATION FOR SANITATION PERMIT Permit No. -�................ <br /> (Comp0���p�f� U� -'^ � <br /> lete , -- Dot, |isue6 _-L...-........Application is hereby made to the 6�' <br /> San Joaquin Local HealfhDist rictfor opermit to construct and install the work herein described. <br /> This application mmade mcompliance with County Ordinance N 549 <br /> B <br /> Address __' <br /> Contractor's /vummoe <br /> ^'~~'~^^~' will ~~'~~ ^="'"=`e � <br /> .""",pn, of ,wv"g unn?- -��./�umber or .^ ---mumber of bu�� J--' Lot woo 1,0P............................. ' <br /> Water Supply: Pu6| � <br /> Character osoil tomdepth of 3 Sand E] GravelU Sandy mu U Loam E] Clay E] Adobe @- nurdpan � <br /> � � , �� pH�/VA. Y�* �] N�Previous Application Km6m: (|[ve- No ^~�' Ne* ~~.~ .-._' Y�, [] No � <br /> TYPE OF INSTALLATION AND::SPECIFICATIONS: <br /> ' <br /> (No septic tank or cesspool"permiffed if public sewer is available within 200 feet.) <br /> Disposal Field: Distance from nearest well---- Distance from foue8ation... to nearest lot <br /> Number of lines------------ Length-of each line. <br /> ---,-�- ' '� Distance- to nearest— '---' `~w~'~~ ^ ''~~^~~-' to ^~~'""' ' "''=^--' - ~ <br /> 95-1- Number of pits ---- <br /> -- -- ' mmho�a Size: D�mmfa --_Depth . --_-_' <br /> ^ r� <br /> Cesspool: Distance from earesf well _- ........Distance from founduMo7n__`_-.,-7.. | <br /> S�a' D�mote,�-._--'--____Deo�--__---_- '''--.--- - -_.'---__-gmi� � <br /> . � v <br /> Privy: Distance from nearestvvuU''''�--''---'__.''''-''D�tuncefrom nearestbuilding------------------------------------------- <br /> [] CUstaqqe *z nearest lot <br /> .- <br /> line <br /> _-_' .. --_.-' �L�. <br /> -----_. .--_-_..'- <br /> -------------- <br /> Remodeling on6/q, repairing �em��m �-'''-- 10 _ _.____ <br /> ___...____--__..-�..--.---__--_-------_____-__'._ _..-__-.-__--__.__-_-__._-- ---_ ^ <br /> '---'-'--'__.-'�_'_-.'__--''-_-___.'----_- .__�__.--__----'--'--.-._-_----._____.--.--..- <br /> '--'---'- <br /> I hereby certify that'I have <br /> �| <br /> prepared this application and that the work will be done in accordance with -n Joaquin <br /> _ County- <br /> ordinances, State la=` nd rules and regulationsof +he San JoaquinLocal Health District. <br /> ��W����!- <br /> `-.`,--,- ---------------------------------------------_---� Contractor) <br /> B�__.-_---- -------.- <br /> �� ��. �m�� �� � �� ��� mfm�m � ��m +� ��� �� �� �� o�� �n ��� 6de1 <br /> ` . �� �� _-_'=` ,-_- , � <br /> APPLICATIONFOR DEPARTMENT USE ONLY <br /> ^ ACCEPTED BY �v^~' DATE--- '._^m�.°�--'_____.. � <br /> REVIEWEDBY----------------------------------------- -----------------------_--'-'--_---_-__.._ DATE- ' <br /> bU|UDiNG' PERM|T/SSUED----------------- ~ - D/g�' ' <br /> -------''--'''-''--'--''''-'--'---- ''-''--'-''-''---'-'---'- ' <br /> Alterations ..__. <br /> -'��'(�'�--'���'�°�z��'' ^���'~@�w�---���f�<°_. *��m��� �_.---1 �.�'-_-_-- / <br /> v � /_ .-----'-------'----'---------------''---'----- ---'--------'------ ^ <br /> .---''--'--'-----_----''--''--'-'''_-''_-''---_-''---'-'--''__-''--'--.'--''-'--''-'-'-- . <br />� <br /> ................................. . ---- -_''-'''-'''-''- -------- ' --------------------------------------------------------------------------------------------- ------------------------- <br /> -.' <br /> - / <br /> nm�`L INSPECTION u,�-v�^-... D�f�.'`�^�� - ����.�----._---._.. <br /> SAW JOAQU|N |HEo�LTH DISTRICT � <br /> 130 South American Street ^ ��L � �� ~ ` �� Street �W��v� <br /> - ' � -'_-' -_ <br /> u��m" California ^L.di,malwor"ia Manteca,California Tracy,California <br /> "° 9 REVISED 8-59 o= "'°' ATLAS -` <br />