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N FOR SANITATION PERMIT Permit------------------------------ -q____�j 0 omplete in Duplicate) No <br /> Previous -1 This Permit 9mires I Year From Date Issued Date Issued ------- �4 <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described, <br /> This application is made in compliance with County Ordinance No. 549. <br /> JOB ADDRESS AND OC� 0 <br /> ------------------------------------------ <br /> Installation will serve: Residence 03"Apartment House 0 Commercial [] Trailer Court 0 Motel El Other E3 <br /> Number of living units: ,I---- Number of bedroom,4_3.--- Number of baths ---'Z>—Lot size <br /> Water Supply: Public system OR"'Community system [:] Private [_1 Depth to Water Table <br /> Character of soil to a depth of 3 feet: Sand Ej Gravel [:] Sa��am 0 Clay Loam E] Clay be Hardpan <br /> Application' Made: ,. yes,date No �� Nmv Construction: Yes [] No . Yp, �� NoE�---- <br /> El <br /> TYPE ��F |N6TALLAT|��N /�N0SPEC|Fk�AT��NS; �~ �' ` '� ' <br /> (No septic tank or cesspool permitted if public sewer is avaUm6kn within 300 feet) <br /> Septic Tank: Distance from nearest wefL----.-Dis+anco from foun6atoo <br /> ' ----Wo+o,iu|LJ No. ofcompartments ------..S�� —_—.__-�qui� 6opm-----.- <br /> --'—C——op—o—c�—y— <br /> ----------------------- <br /> Disposal <br /> --'--'' <br /> -D� | F�� Distance from nou,00 well. Distance from �mn6uf�n ----Di�n»c* to nearest lot Sn --------------- <br /> ^1 <br /> `"" "�, of |inos----------------------------------Lengtof each line--------------------- oftrench <br /> T'.� of filter material _ ._—.—D�� � �� mutano/-----------------------Total <br /> --------' � <br /> |ongf6_-__---_ <br /> ,,&mber of pits--)--------- --------Lining material-1/ ----.--Size: Diameter__�j_:�?--------Depth��.�-O <br /> �Z,_. / Distance from nearest <br /> _110 <br /> [] �e'/—'-----'''--'--'----�-----'— <br /> - ^ <br /> - etnom foundation ----�n�g materia <br /> l Diameter ''_'--''—'—''Dooth —'--- � '------'-- <br /> P,�v: Distance from nearest well '--.—'----'-- oui6 Capacity '—'go|s. <br /> [] Disfnco,tonearest lot * --D'b+onco from nearest building------------- <br /> RemoJeing and/or repairing (describe):---------- — -----��'���-��-�' <br /> -_—___--__—_--_'_--.----___-----_--_—_----______--_--_---_—__—'—__--_ <br /> -------_—.---._--______--_-- ------- <br /> ---_—.---_—_—._----_--_'—_--__---___—___' _—.----___----_-----' <br /> i hereby certif, a have pr '0 application and that the work will be done in accordance with San Joaquin County <br /> ordinances. State a[, s, rules ae'p re"gullons of the San Joaquin Local Health District. <br /> i n of sys�m i elai� n o we s, etc., can be placed on reverse si_dile�.— <br /> FOR DEPARTMENT USE ONLY <br /> --------------------------------- <br /> FINAL INSPECTION 8Y /i <br /> . '_+^_.�*��x,���---'_-----. <br /> SAN JOAQUIN|N LOCALHEALTH DISTRICT <br /> 1601 E.woxelton Ave. mmWest Oak Street 124 Sycamore Street 205 West 9th Street <br /> »���n California L"a�ea"=� Manteca,California n"",'o"o��� <br /> ES 9 R=..°cD °'s° "° o'°" "P.cp. <br />__ <br />