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` 0 <y <br /> APPLICATION FOR SANITATION-- -'~ ` PERMIT Permit No <br /> `--'- <br /> in x+� ' ~~ <br /> (Complete— — --'--' 2iihy�,Issu-o6 - --1�/-/� <br /> ./ - <br /> hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> Th�plicatio pplica.tio# is madein compliancewith County <br /> JOB ADDRESS AND LOCATION_ ---------------------_.----.--------'- <br /> uwnw --__-----._�_-�_----. Phone--__---'__._. <br /> ' . . '' '---' '''''_-.''-------__.' <br /> ---- <br /> Contractor's Nomn._^_ .��. _------------.-------�_._--_-_- Phone-----.--__- <br /> Installation will serve: Residence EApaHmer)f Houm`E] Commercial- E] lra)[en Court E] Mofe| [-] Other �] � <br /> Number of living units: ^r- Number nfbedrooms J ' Number of baths Z Lot size ^��.~ ..~-- ----------------- <br /> '��»~ <br /> VVate, Supply: Public ,y,fom ��� Commun;fy ^y,h:m El Private E] Depth to Water Table ,��� f+. <br /> Character of soil to depth of feet: Sand E] Gravel E] Sandy LoomClay Loam E] Clay E] Adobe Ef°_-_Hu,6pmn [] <br /> Previous Application Made: Yes [] No 20'-Na* Construction: Ye, E] No gj~~~_FHA/VA. Yes E] No Z�~-' <br /> TYPE C>FINSTALLATION AND SPECIFICATIONS: <br /> /N0009fic tankor'cesspooINpermiffed if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well-- x�2� <br /> No. o{ compurhnen/s-�����-.--'�Si�o..��'��.e�..1�^��-'Liquom foundation---i6 depthh-- <br /> --'C"poci+y-. �p ��. <br /> - <br /> . DisposalmDisposal�~~~|~^Field:e|�� Distance from well, —------Distance from foundation /� *. Distance = ~~ ~'"' <br /> idth <br /> ^Number of lines - Length of each |inn . V --_-. <br /> Typo of filter mo+erio - �Depth of filter mufuri*L. � -..To+o| length--u� � .��----'_. <br /> 3o t Distance to neun:� weU_.�—�_. /e/___` to nearest <br /> Number ofp�, -' ^ '—�n�gmo ;9L -Size: Diamefe <br /> ~vDeo+6 ''OZ&--------------------- <br /> Cesspool: <br /> ''--'Co, poo|: Distance from nearest well-----------------Distance from founclu�ion--------------------Lining motoriuL.--_------- » <br /> [] Size. Diameter ''--_'-'-''—''—Depth'''-���'�_-�''_'''----Liquid Capacity '-����-''-'.gals. <br /> � � <br /> Privy: Distance from nooro, wnU—'---'''_-'''-''''-''Di,|once �nzm nearest building------------------------------------------ <br /> �] <br /> Distance to nearest |o+ |ine ~�U <br /> , <br /> ' <br /> Remodeling and/or repairing (ooxcnbe):------.-o���u- ------------------------------__._-_.---___._ <br /> ---------------------' -----''--'' - -------'------'---`---- <br /> ------' --------------- °`--'----------------'' <br /> --__-_-__----..__-__-.___-_.__.----___--._-_-- _---_----__----._-----� <br /> | hereby certify that | have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulat. ns pff/jhe San Joaquin Local. Health District. <br /> -------------------- <br /> (Plot plan, showing size of lot, location of m in relation to wplls, buildingi, etc., can-6e placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> BU|LD|NE> PERMIT ISSUED-------------------------------------------------------------- DATE--------------------------- ��'-�'''-'--'— <br /> &lto,mtionsand/or recommendations:-------------- --- ---------------------------------------------------------------------------------------------------------------------------------------- <br /> -----------------------------``--` --------------------------------------------------------- ---------------------------------------------------- <br /> ----------------------------- '��n� '--~^------'''---''----''''-------' <br /> _-_-.- .����---------------------------------� '''--_'--''--- <br /> -'--'- ' '_--- -���--'�-'''''°'^~ ^^~.~.'-_''''--'-'-''-�-' <br /> � _ <br /> FINAL INSPECTION Dn��-�����/,-.—,~� �� -----------_ <br /> SAN JOAQUUN LOCAL HEALTH UUSTR CT <br /> ` . ` <br /> /xu South <br /> American �,w� 300 West d° a�°° ^ ` ' ba Sycamore Street ' nw w"*h "C" Street <br /> Stockton, California Lodi, California Maomoo California Tmov California <br />