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� <br /> .1 <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br /> - Duplicate)7n <br /> ^ -`- -` Dofo |u,u »-^ <br /> qra6v made to the San Joaquin Local Health Dist rictfor permit to construct and install the work herein described. <br /> ' -`^'~ ~n''~~^~' '^ ^~~~ in complia' <br /> C o n t ra cf o r'5 N aLm T)_ - <br /> Installation will ser�e: Residence [3- Apartment--House D Commercial Trailer Court 0 Motel Other <br /> Number of living units: Number of bedrooms Number of baths �__ --- Lot size /n(fv-------A__S__K70---------- <br /> Water Supply: Public system 0%�,&mmunity system C] Private Depth to Water Table 40- ft. <br /> Character-of soil to a depth of 3 fee�. Sand E] Gravel F] , Sandy Loam F1 Clay Loam [] Clay Adobe El Hardpan [-I <br /> Previous Application Made: Yes [I No ?Vf' New Construction: Yes El No <br /> TYPE OF INSTALLATION-AND-SPECI F1 CATIONS <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well,-bV.- Distance fr�m foundation-A9- Cc -------------------- <br /> Disposal Field: Distance from nearest well-29e... Distance from f0undat"i'l-7Z----- _.Dis+a�nce to nea"rest lot line��s..... <br /> Se pa e Pit: Di'stanee to nearest well_�411$�Z7_1----Distance 4mm fo daf- -:129- isf nip to nearest-joi,lillo--so------ <br /> Di = <br /> / ~Cesspool: - ^ ' ' ' <br /> �a000 � Distance from nna"a� W*L'`--�_Distance from foundation -''''---�U;ing material---------------------------- <br /> _� <br /> [1 Size: D�mofoc-'-�__-_�.--Depth__----____-_-�__--�qui6 Capacity--..-�_-__-ga|� <br /> P Distance from APPLICATION ' <br /> �ol ling lo 6, a; legrib ------ _­­�-------------- ----- <br /> ...Zp <br /> I hereby certify that I have prepared this applicati n d that the work "11-66 don- �pprdance with San Joaquin County <br /> oca <br /> ---------- - - --------- ------ -- ----- --(Owner an Z/ Confna to <br /> (Signed)-------All . ..... <br /> on ree rse side). <br /> (Plot plan. show size of lot, location of system in re ion to wells. buildings, etc., can 66'place <br /> FOR DEPARTMENT UtE ONLY <br /> ACCEPTED .......~-'''---_'' ---- ----�''''-'_-----_--'''''''�- _'.__-___ ~ �''----_-'---- <br />- RPME\*ED BY----------- -''-����-'--''_''---'--------.''��'-- DATE <br /> BUILDING BUILDINGPERW|T |SSU�D-_--_��_.__.------_'-_.__-�-�-.�_-��.-- D�TE'-----_._---.-_._____.. <br /> Alterations and/or ,enomman6allonu�_-_.-------------'__.-:�......... - ______________._____._.. <br /> ----_-''_-_-'''-'--_--'��'----.'''''''''''-'--.'-''''---''''��'^-^''-,-'���--.''�''''''_-___''___.__.._- \ <br /> .__-----._--_---.',._-__--__--.-..`,,==_.--- --`--~~ ° ��� __~_. <br /> ------~- � '- ---'— --'-^'-----'-- <br /> -__-_-_--_--------._-.___---.-__--------._.___._._-___-------_-._.__.._'--' <br /> -'-'''-''-'---''''''''----'''''�- --_---�'�''''''-----''-''-_-'��'_----.'''-_.'''-_ <br /> RN/\L INSPECTION BY:------- ---------------------- Du+e --.__--______ _ <br /> SAN J[4\QU|NLOCAL HEALTH DISTRICT <br /> /30 South American Street 300 West Oakafreet 132 Sycamore Street 814 North "C' Sfreef . <br /> ° u <br /> Stockton, C�I«"r.nia Lodi, California Manteca, California Tm"» California <br /> ES-9-2M o's/ n°~/"°a W-2/00 <br />