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x <br />� <br /> APPLICATION FOR SANITATION PERMIT Permit No. ------ <br /> ^ �umn�m � C�o�a� � <br />� `--`-- '---' Date IssuedApplication is hereby made to the San Joaquin Local Healfk District for a permit to consfruo4fand install the work herein described. <br /> r <br /> This application is made in compliance with County Ordinance No. 549. <br />/ <br />�' ~~~ '~~~.ES. AND <br /> ' �r ~�rp <br /> Installation will serve: Residence Apartment House Commercial D Trailer Court E] M?teI El Q*er El <br /> Number o-f living units: Number of bedroom;p;_�2 _ Number of baths /-- Lot size ----�ad- - ------------ <br /> Water Supply: Public system)K Community system 0 Private E] Depth to Wafer Table ft. <br /> Character of soil to a depth of 3 feet: Sand 0 Gravel El Sandy Loam [:1 Clay Loam Clay Adobe Hardpan Ej <br /> Previous Application Made: Yes E] No V New Construction: Yes E] N <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> - - (No'-so9fic � <br /> of <br /> artments <br /> ze <br /> uid <br /> th <br />/ ° Capacity <br /> --- <br /> Disposal ." *' "."""": .."= ":*n�r u/uunc* from foundation_ <br /> ~ <br /> Width <br /> -~ � �^ ° ' �~ <br /> Typo of filter mofe,iu| -..Depfk of filter mo+erioL..��.~*--.-.�otu| length---��x0-. <br /> ---------------------- <br /> Seepage Pit' Distance � n��� well �|dnn� from ��n6n�o�_. Dis�ncn � n��� |� |in ----------------- <br /> [I <br />� . _---_-. -''_- -.-.-_ <br />` [] Numberof pits-' ------------------Linin g material '''''---_Size: Diameter------------------------Dept h--------------------------------- <br /> Cesspool: <br /> '-''-'-_.--''-C000pn : Distance from nearest we|l-----------------Distance from foundation------ Lining material _------___._ - <br /> Size: Diame+o,'--_r-'''--'-_-Deoth-_.'''''''''-__'''''''--Uouk] Cupoc�y.-'__.-___-oa�«�� ^ <br /> D�� �o'm no��.f || D��� 6n b \' i- - - -~- <br />` El . " <br />` <br />/ <br />| RemodnU"g and/or repairing (describe):------------ --- ________. <br /> ----------------`---''---'-----'- -----------''--'-------'—'' <br /> ---.-_____'_---_-______-_-_-__.-^`_--___�.-__'___---_______'-_----.___'__-----'--_.- / <br /> ---------`---```---`---``-------`----''-----------------'---'----------'--------- <br /> I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ------- State wi,ynd ru a d, regulations of the San Joaquin Local Health District. <br /> . ^ <br />� <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY-(,--BUILDING PERMIT ISSUED � <br /> --------------- ��� �� �� DATE_-'_--+,-----------_..--- . <br /> ��e,uNon� unJ/nrno�omm*n6a�nny�--�3���1-�'.. .�1��u����'°�''y��.---.-----.---------------___.-- <br /> '------'---^----------------'---t�-------------'---'---''----------''--'—'—' <br /> -----_---__------_---------_--_--------'_---------- --------- ---------__--------___-----------__������'--__----_�--__��---_____-----------___---------_------'-----_---------- <br /> _-__-_--_----_-_-.----__--._-_---_--__-._----._-__----_-_--�---'----.__- . <br />( ----------�'--'''---''''--''--'''-'''''--'''''--'--' ''''''''''''-''--'--'''''�-�'''--------'--'-'-- <br />| <br /> FINAL INSPECTION BY:.-.. -'--_.. D�fu----/.�.���-�x���~ -------------------------- <br /> _-_ <br /> � SAN JOAQU|N LOCAL HEALTH DISTRICT ' <br /> - <br /> /30 south America" Street 30D West Oak Street 132 Sycamore Street 814 North "C" Street <br /> smvktvv. California , Lodi, California Manteca, California T=ov California <br />� E*-v�-xw 8,5/ Revised vv�2/00 | <br />