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/ <br /> A1111CATION FOR SANITATION IERIAIT Permit No. ' <br /> | --- <br /> `--' ' - /n Duplicate) <br /> Date Issued �O ' <br /> ishereby made to the San Local Health District for a permit toconstmct and instuUthe wor herein described. <br /> T <br /> isapplication ismade in compliance with County Ordinance No. 549. <br /> J{J8 ADDRESS AND LOCATION-_.. _-64.------ ------_--___._. _-' __ <br /> [wmn,oNumo'--''_-_- E~ '-__6 ^2 '--�--��'�'��-''�--'-- ph»n <br /> - <br /> Address-.-----_. ------^�w��--' �����----------------------------------------------------------------------- ------------_..-.--- <br /> Contractor's Name---------------- '---''-'''_-.''-''''--.'- '--'-----'-- Phone'' <br /> Installation will <br /> ^serve: Residence [] Apartment House E] Commercial Uer Court | Motel � Other �] <br /> �� <br /> Number of living un|to �---' Number of6oJmnm, --.. Number of baths Lot Lp+ sizn x���.w����--_---.- <br /> Water Supply; -Public system El Communfify system [:] Private Eff- 6epfh toWafer Table 45'�f <br /> Character of soil to a depth of fno+ Sand 0 Gravel El Sandy Loam 0 Clay Loam E] Clay E] /\6 Hardpan [] <br /> _-^�. <br /> Previous Application Made: Y�oU�� mo E] New Cnn`tm Y [] pHA/VA. Yes L] No �� <br /> �+� <br /> � TYPE <�F INSTALLATION AND SPECIFICATIONS: '--- <br /> r . <br /> (No septic tank or'ce,spoo| permitted if pu6|icsewer lsa°a8a6|ew�6|n 200 feet.) <br /> + <br /> ' - ~ ~~� ^�, <br /> Se �nk� Distance f,o��naores+ wmU--����--Dis+�nco f ivn-����--'.���oter�L. <br /> Septic Nn. n[ compartments--------- ��� ��_-Uqui6 depth A�,---/Cupocjfy.. <br /> / Disposal Field: ,| from wr <br /> .,.^.-~. of ---------------- . --_ line----------__. Width_ of trench-__. <br /> ' - Type of filter mof=riaL.-/iF����EfJ]up+h/z fi�nrmoh,h�L-�����--To+ | length--'-. -_.���--__.. <br /> ' ' � <br /> Seepage Pit:,.. ' s-ncejo foundation-------- n;u������ |�"�---_- <br /> Number of pifs---� ------- -------Lining-material '---''''-'Size: Diameter'_-.--'--Depth '-''-'-'_-'''' <br /> : Distance from nearest well --''-fDistance from foun6ot�on-''''-''-Lining material '-''-'--'--'''- <br /> Size: Diamotoc-----------�Dvpfh----.-__--_---'_..Uqui6 /�apnc�y._--_����--go|s. 4J <br /> � <br /> Privy: bisfnnoo from nearest well------------------''�'''-�'''--Distance from naans+ 6uilding�,-�--'---,'-'-'- \ ` <br /> ElDistance to nearest lot Uno-------- .------_--.-.__-.__.-----..^-_-_--_------.-_-' <br /> Remodeling and/or <br /> ------------- <br /> 1 hereby certify that I have prepared this applicati6n and that the work will be done in accordance withi. San Joaquin County <br /> ordinances, State laws, and rules and regu�lations of fhe,San Joaquin Local Health District. <br /> . . <br /> jitle <br /> nl <br /> oy- <br /> ,j_ntra <br /> | <br /> By: - ' <br /> . plan, showingsize, <br /> of lot, location of system in relati I on to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> ` ----__.- .--._--... DATE_ ,._--_.--___.._ <br /> - ^ � <br /> Alterations and/or recommendations: '�-'-''__.''-_.''-_--''__''-__--__.'------------------------------------ <br /> ----' --'\= --,----'— --'--- -- ------------------ <br /> --------------- <br /> --' <br /> + �� ���,aax_*m ~���m��~~����+�� . ., � ~ -��^x �� ---------------- <br /> ---- <br /> �~=�- ^~'-----' -'-� '7'--'' i/ -' -'' '-'--'' --- <br /> _-_-._-__--.___'--_---_--_----._-_-_._-_---__-_--._--._-._--_-.-__--__. <br /> --',-''--''---'''-'''' --''--'''-''-'--`-'-'_-'-- <br /> ' <br /> ' , <br /> / FINAL INSPECTION BY: Ou+e -'''�z2 -`�0�`----- --------------------- <br /> SAN <br /> JOAQUINLOCALHEALTHD1STRICT <br /> c�^ <br /> � <br /> 130 South American Street 300 West Oak Street /32 Sycamore Street 814 North "C" Street <br /> Stockton, California Lodi. California Manteca, California � �`-' �nao» California� <br /> / <br /> ES-9-2M ' n".;s°" 1'57 p.pcu <br /> ' <br />