Laserfiche WebLink
TF <br /> APKICAfil� �#"� k1btoft <br /> (Complete in Dupl�safo_ <br />,. Dato Issue t <br /> _..._. <br /> Appl3e►ti©n is hereby made to the San Joaquin Local Hoolth District for a permit t'Wcc strctc#entl i all,,0 s tork.heroin dgsscri <br /> tris application is made in compliance with County-Orcti>nence No. S+iA. , <br /> JOB ADDRESS A CATI `" <br /> ". yy <br /> Owner's Na - - -.. Phare <br /> k Address ...., <br /> Contractor's Name <br /> 6 f Y <br /> y <br /> Installation will serve: esi encu.Api+rtment House ❑ Commercial ❑ •r ours''❑ ` Ivld#+i s� [ q, <br /> Number of living units: _____ Number of�iedrooms ._- Number s,f bad 0t . <br /> sw <br /> Vater Supply; ,Public system ❑ Community system ❑ Private' Depth to Water Table f# <br /> Charadlder of soil:`to a de th of 3 feet: Sand Gravel Sandam Cl <br /> w . <br /> e <br /> p Q CF y L� ` 1. ClaySK <br /> 'g <br /> Jf Prevww A�ca#ion Made: Yes Q; Na New Construction: Yss ❑.;No <br /> TYPE OF INSTALLATJON ANp SPECFICATtONS, <br /> m (No septic tank or cessptsol permitted if pubic sewer is av'ar�a�i a w" <br /> ptic-flank: Distance from nearest well Distance from- <br /> ---- <br /> rom foundatrQn• ... . tam � .. ; , <br /> ' No. of,compartments---. Size _._..L�quicl clept�h¢ <br /> , } <br /> sposal Fi Id:. istance from nearest well Distance°fmm fii undetO <br /> Ntier of finest ...., Lens�th ,o# each line <br /> 'typo of f+fter'Moteriel .. Deptlz.�f filter mate; � _ � <br /> ^ x £ <br /> epa -e Pit: Distance to, �� ` <br /> �# atll _.D{sta fo ti{ t <br /> plumber of pats .:_ Laner� mai�eria -Sfzo er <br /> sspool: �,' Distance"from nearest'well.... -._.-Distance fr undo#fan -•---•-----,� ,^ �... s' ._ <br /> `Size Diameter._. - �Depth ----------------- <br /> Eli uid <br /> �y _ <br /> .jjij� . It aTe$t W --s <br /> m �•� �Ce,to neatos lot:�fn _ .�.<. - - �,* ."'. s,,r. ,.s-''•'--•a---�'" <br /> r <br /> i Jar r ng (desc.r` <br /> • <br /> ._ __...... rw <br /> et r app{tca}� t ewe wig be he Is-As <br /> III p <br /> an rules tsoasr:v#the Sat+ Local He�Ith , <br /> s -- <br /> K <br /> shoring she of loc n f "stem in relation to wells, bwldia s, etc, can,be lac, on revQrse side '' <br /> sY g p � <br /> FOR IAPARTM <br /> ry PLICAI7ON ACCEPTE6 k'3Y.. . -- - D z, <br /> l E�/►�ED SY7,77 <br /> - - f?ATIw <br /> .._. <br /> iLllPlG iRMlr�s� ►1= _ �. Ir . ,y ". <br /> its ancf � #ions: -- ,.,.77 . <br /> _- .:_ _ <br /> _ K . <br /> l~INAL f5 . . Date.. - <br /> S �"WCAl=HEALTH DISTRICT <br /> F34 South'A iva': e�t- fi11 Wist 0A Ur !32 Sr i <br /> Stotktoei, ICaliFotni� lfOoi, <br /> Ce 's Mentrca f r iar , Ch '„; <br /> $—$-2RiI $e51 <br /> iii iW-2100 <br />