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~� � APPLICATION FOR SANITATION PERMIT Permit No. � C�m�m�\ � (Complete- - '---' Date |s,uo6 ------------- hereby� made to the San Joaquin Local Health District for ndinsfal�fhhe herein described. 's application is made in compliance with County Ordinance No. 549. JOB ADDRESS ANN.-----W#26�11,q --------m5v_ ��-��. Owner's , ----------------------- --. ------------ ?hone---.-----._-.----.. AJ6m«s--------- - ---'_----'--.-----._.............. .. - one- Contractor's Nomn-. .. ----------------------' phone. Installation will serve. Rosidencojo Apartment House [] Commercial [] Trailer Court [] Motel [] [)U`ar [] � Number ofliving units: �--- Number ofbedrooms -_ffNumber ofba+hs '.e'-2—Lotsize .. ^�«�,---- --.��-��..�---' � _-_ � Wafer Supply: Public system Community system j&-Private 0 Depth to Wafer Table J� Character mfsoil to a depth nf3 feet: Sand [] Gravel El Sandy Loam E] [1oy Loam El [1oy [] Adobe Hur6oun [] Previous Application Made: Yes [] No N�-- New Construction: Yo, ��. No �] . � TYPE OF INSTALLATION AND SPECIFICATIONS: (Nn septic tank orcesspool-permitted if public sewer |vavailable within 200 feet.) . Septic Tank: Distance from nno,00t *e -'Dis+once from ^» fovo6u+ion.. O----k1uturial,.&� .. ---__- 0q No. of compartments-. ~t ----.size-... ~u��.��.�� Liquid 6 h u��' ~' C x?0-kJ ...Distance to nearest lot line__,6401--- .. 1. Dispusa| Ho|6: Distance from nearest we4;.2VV.._- y --� � fo �J��r� Number of lines. � ' �n - o�� 6 | � i �� o{ french o T,pe of filter m*�v, ,| / .Uup+6 of fi|fe, material.. -Totu| length--- ----- Soepage Pit Distance fo nearest well------ ------------Distance from foundation--------------------Distance to nearest lot line-----' . F-1 , Number of p|ts-------iining m^tdrioL-.------Iiz°: Diameter---------- --- ----.Depth---------- -.----,` : Disfance from nearest well ''_--Distance fn,mfoum6o6pn--''---Uning moforioL'''--------''-- ' El Size: Diameter.--.--.-------Dept h--------- ------------------- ------- --------------Liquid Cupacih--_--_—''go|s. Privy- Distance from nearest °eU-----------------------------------------------Distance from nearest building '----'_-_._----' Distance hznearest fat |;oe - ------------------ - ----------------------------------------------------------------------------- --------- Remo6eingand/or repairing (describe):------------------------------------ ---------------------------------------------------------- -------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------' - '------'--''-----''----''-'''--''----''--''-------'--'---'--'--''''-'''----'---''---'-'-' .—_-.—_---------.__.—.__.-._-_----_----_---_-___.--_-._-_-._-------__--__---- ' the work will be done in accordance with San Joaquin County ordinances, State and rules and regulations of the San Joaquin Local Health District. (Plot pl n. s o wing si a of lot. ocation system in relation to wells, buildings, efc, can be placed on reverse side). , FOR DEPARTMENT UDEONLY BUILDING PERMIT ISSUED------------ RA Alterations 11 ' and/or--'-------'------------------------'-------------------�'— -'---'------' ________________________�__-__�____-_______________________________________________'______' '---'---''''---'--'----'------''---'---'-'''-'''--'''-'-'''--''-'''--''-'-'--'-----'--- '----'''-''''--'--'--'-'''—�— - ------- ------ ---'---''-'—'-'-''-''—'-''-'''-''''-------- -------------- ----' F|N \L INSPECTION 8Y:- Du+o '� �_ / _ q� �=�- . /.. .. -- �-------- ---_---_.. S4N ~ ~ JOAQ0N LOCAL HEALTH DISTRICT 130 South American Street 3ooWest Oak Street muSycamore Street nwNorth ^C^ Street Stockton, California Lodi, California Manteca, California Tracy, California ' "s-y 14S446^,°CU"