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APPLICATION FOR SANITATION PERMIT Permit No. <br /> V ap_.Al" (Complete in Duplicate) Date Issued <br /> ,- - <br /> plicafion is hereby made to the San Joaquin Loxa| Health District for u permit to construct and |nstoU+he work herein described. <br /> gA <br /> is dpplicafiori is made in compliancewith County n6 N <br /> Installation will serve: Residence/E��Aparfmenf House E] Commercial E] Trailer Court Motel E] Other E] <br /> 49 <br /> Water I Supply: Public system ���mmunity system El Private E] Depth to Wafer Table __,Lt0ft. <br /> Character of soil to a depth of 3 feet: Sand P--,,Gravel E] Sandy Loam E] Clay L am 0 Clay 0 Adobe W//Hadpan El <br /> Previous Application Made: Yes E] No'W New Construction: Yes Ej No [�j FHA/VA- Yes E] No <br /> INSTALLATION N SPECIFICATIONS: <br /> t",o septic tank or'cesspool permitted R.pm6Gc oown, is available within 200 tent.) ^ <br /> ic Tank- Distance from nearest well ----.-Distance from foundation--------------------Material --------.-------- <br /> Noof compartments Size--------------- Liqui6Je'p+ Capacity_ <br /> posi�� Id: Distance from neare I weII.A_(?fk0__Distance from foundation---10-----------Distance to nearest lot line <br />. N 6 f |i � <br /> » L� +6 F 6 |l �/" VVi6fh [ f ' <br /> �� <br /> o/-c-S_—/oru/ /ungm_---_^Zxa-.---. ~~yp� oormovrupo � e, mo ,n <br /> � f �� <br /> Soepu � Disancr 6 | | U� <br /> m�~- Mum6o, of �+`��I�''�''-Uning Ir - ~- <br /> Cesspool: Distance from nearest well-----------------Distance from foundation------------------- Lining muturiaL---------__ <br /> [] Size; Diameter --'''-''' -------------Dept k-''''''''���'_''''''''-_Liquid Capacity----------------------------gal s. <br /> Privy: Distance from nearest well-_-''_'''-''''�'�_-Distance from nearest building'---''_-'-----.'- <br /> ElDistace to nearest |o+ line-----, ��--��---_------_ � <br />` � <br /> Remodeling and/or ,apuiring '--''-''_'-______'__ <br /> --_'_-----------_.--_-----------_-_.�^'�__----------.. ---.-------------_-.--.---._------- , <br /> .-----_-.----_--__...=-_-____..___.--__-_-__'__.-.-----�___._---.__-- ------------------------------------------------ <br /> --------- <br /> .__.___._-.--.—.. <br /> '-'-�'__'''-_-'_-_-'-_.'''__.''-_''__'_-_'''-___''''----'''__.''--''-'---'''__._-'-''-'-'�'���- <br /> prepared f6& application and that +ho work will be done in accordancewith San Joaquin County <br /> ordinances, State laws, and rules and reg Lations of the San Joaquin Local Health District. <br /> P mJr_w�-�^g^�� �c �m �«�f/ � 4| '=�^ w � �a^°�wa <br /> ° <br /> ------------------------------------------------------------------------------- - ---- -----/Ax, ---(Title)---------------------------------------------------------------- <br /> (Plot plan. showing size of lot, location of system in relation to w buildings, e-,t , can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> /\PPL|<�AT|[)N ACCEPTED 8Y D/\TE <br /> -----� -----------------' --7'-l���n ~-------__. <br /> REVIEWEDBY-------------------------------------------- -----..--_--------. DATE-��-------------------------------------------------- <br /> BUILDINGPERMIT ISSUED---------------------------------------------------- ------ ------------------------------------ ' DATE------------------------------------------------------------- <br /> Alterationsand/or recommendations:------------------------------------------------------------------------------------------------------------------------------------------------------------ <br /> -----­------------------------ <br /> ____.__ <br /> ----'����������---'��----'������������������������--------------------`----------------------`---------------'--------------'------'----------- <br /> -^----'--''-__.''-_-'_-''''--'''--''-'--''---''�'-__-�'�''--'''--_-''__.'''_-''--'-----_.-_.'_-- <br />| -------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> --------------------------------------_-------_-----___-----____-----____----____���__---------________-----___-------------____---____���_�_�---_--__-------------� <br /> > <br /> FINAL INSPECTION BY: -'--'''-_-'- Du+o -'''-,/''��,w-��-'--''----_'-'---- <br /> _ SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> ' <br /> � /30 South Arnorica" Street 300 West Oak Street 132 Sycamore street ow North 'C" street <br /> Stockton, California Lod|, California wamwno. California Tracy, California <br />