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------------ <br /> V APPLICATION FOR SANITATION PERMIT hrmit No. ...... .............. <br /> ......+Ut---------------- Date Issued ...... /raj <br /> T�plication is here* made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> 's application is made in compliance with County Ordinance No. 5 9. <br /> Installation will serve: Residence R3""Apartment House F]' Commercial [] Trailer Court E] Motel Other E] <br /> Number of livin units: J--- Number of bedrooms ___'30_" Number of baths A--- Lot size ................------- <br /> Water Supply: Public system [-] Community system F1 Private RR'lepth to Water Table .7-49- ft. <br /> Character of soil to a depth of 3 feet: Sand E] Gravel F-1 Sandy Loam [] Clay Loam [:] Clay E] Adobe 2�0�arclpan C] <br /> Previous Application"Made: (If yes,date------------------._) No 5a'New Construction: Yes Ri—No Ej FHA/VA: Yes Rq—No 71 <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tan or cesspool permitted if public sewer is available within.200 feet.) <br /> Septic Tank: Distance from nearest well_,/,90' _F---Distance from jounclation-----le-------Material--- --------------- <br /> Disposa�l Field: Distance from-nearest .........Distance to nearest lot line. <br /> m founclati 13 <br /> Seepage Pit: Distance to nearest weIL__,/_W_ r------Distance �ro' on...e�_._`Distance to nearest lot line-.0-------------- <br /> deling and/or repairing, (descr <br /> I hereby certify f hat I have prepared this applicaf ion and,f hat the work will be done in accordance 'With San Joaquin County <br /> ordinances, State laws, and rules ;apd regulations of the San Joaquin Local Health District. <br /> (Plot plan, showing size of lot, location of syst n 'relation to wells, 6u'10ings, etc., can,be placed on reverse side). <br /> . <br /> ----------------- --------------------------------- ---------------------------------- ---------------------------------------------------------`r---- ----------------- ---------------------------------- <br /> ' <br /> \------------ ------------------------------- -_----_—'---_----'--_.-----'-_'---,----''—_—'-- ' <br /> '^ ` �� . <br /> H INSPECTION' .�—--------------------- Dm+�. ^ _.-----.—.— ------------ <br /> . .1 <br /> SANJOAQU|NLOCAL HEALTH DISTRICT <br /> � <br /> 730 South American Street uwwWest Oak Street . 2*Sycamore Street uoaWest 9th Street <br /> Stockton,California , Lodi,California � A ����Cw/lforriici� Tracy,California ' <br /> =~=""""~°°=`"�="~" . \ <br />