Laserfiche WebLink
APPLICATION FOR SANITATION PERMIT Permit <br /> (Complete in icate) <br /> Date <br /> T�lplicafion is hereby made to the San Joaquin Local Health Dist rict for a permit to construct and install the work herein described. <br /> is application is made in compliance with County Ordinance No. 549, <br /> ------------------------------ <br /> Ins+allafion will serve: Residence E__A_P­arfmenf House [] Commercial E] Trailer Court [] Motel E] Other Ej <br /> Water Supply: Public system E] Community system F] Private [3--D-e-pth to Wafer Table -------- ft. <br /> Character of soil to a depth of 3 feet: Sand E] Gravel El Sandy Loam El Clay Loam Adobe Hardpan <br /> Previous Application Made: Yes [] No �`ew C'O-nstrucfion. Yes <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public'sewer is available within 200 feet.) <br /> Disposal Field: Di5fance from nearest wel�... Distance from foundation----c'�-_P ------Distance to nearest lot line---- <br /> --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County, <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. mt <br /> (Plot plan, showing.size of lot, locaflon of system in relaf ion to wells, buildings, efc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY------------------------ ---------------------------------------------- DATE---///Y/----�r77�------------------- <br /> -'-''--'--''---'_-'''_--'''-'''''-_'''--''-'''''-'''--_'''---'''-_.-'''---_.''_-''_-'---'-_.---__ / <br /> '__--_--__--------_-_---.__-.-------_'_--__---_-__-__.__-_-_-_-_ <br /> ---_---__---_---------------___-- ____���___ �����_��-------- --------------------- ---------------___---__-----__-----_------------- <br /> �� .� ~~ � �� _^ �� <br /> F|N/\L INSPECTION BY:----------------- Dafe--._~--'.-.-�---�~-.�_.-�-.------. <br /> SAN JOAQ0N LOCAL HEALTH DISTRICT <br /> /nn s""m American Street 000 West Oak Street /32 Sycamore Street m* North "C' St=mt / <br /> Stockton, California Loa/. California -- wam,"a, California n""» California � <br /> / <br /> ES-9--2w ns/ Revised vv�|nn <br /> vvim ` . . / <br />� / <br />