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� <br /> APPLICATION FOR SANITATION PERMIT Permit No 7 ' <br /> , r~~^r^~'~ in Duplicate) Date |ama6// <br /> Applical-ion is rem mo6n to the San Joaquin Local Health Dist rictfor o permit toconstruct and install the work herein described. <br /> This application is made in compliance with County Onainance No. 549. <br /> JOB ADDRESS 7 IONd 4-7-4-7 <br /> Owner'! -- ----- -------- ----------- -- - --- - ---------------------------------------------- --------- -------- Phone# <br /> partment House F] Commercial F] Trailer Court F] Mote) [] Other El <br /> Installation will serve: Residence 5K 1� <br /> Number of living units: drooms 13__ Number of baths _Z_ Lot size <br /> Water Supply. Public system ^ Co�mmnity system [:] private [] Depth to VVute, Table -------- ft <br /> Character of soil to a depth of 3 fee+: .Sa d E Gravel [3 S dy Lo Clay Loam E] Clay E] Adobe ER/Hardpan <br /> Previous Application Made: Yes [] No E; New Constructioar:1 Yes ;�PNO El <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if PU61' sewer .s available within 200 feet) <br /> Se ank: D�stance from nearest wel4p-------- is from,fo nag onl_O_t�_4 <br /> Dis Field: Distance from nearest wplf�-�V&t----�iist�nce from fcundation].L9��istance to near sf I f I' <br /> _(---------- e _4 <br /> p;`11 Number of lines------- Length of each line---------j__0 ----Width Of french-- <br /> epfk of filter materia <br /> 44---------- - <br /> Seepage Pit: Distance to nearest well----------------------Distance from foundation-------------------rDistance to nearest lot line----------------- <br /> Cosspuo|: Distance from nearest well-----------------Distance from foundation------- -------------Lining material------------- <br /> [� Size: D��o+�r-�-----_----Doof ---------------------------------------------------Liquid Capacity:.----- <br /> Privy. Distance from nearest well -'__-'��.''-_.'--.''Distance from nearest building _�'-----------------.''--' \�\ <br /> F-1 Distance fonearest lot line--------------------------------------------- -----------------------------------------------------------------------------------___- , <br /> ' `---`- ���[ ' <br /> �o���nc�x �� �,�.usc^"c^���^-.. <br /> .--_.------------------------------------------------------------------------------------------------------------------------------------ '___''--------------------------------------------------- <br /> ----------------------------------------------------------------------------------------------- --'-'--'----'----'------'--''-------''---'--''--'— <br /> hereby have prepared this application6 +6 +he work will6edone in accordance withSJoaquin County <br /> ordinances, State laws, and fioes and regulations of the San Joaquin LocalHealth District. <br /> 411(Signed)--( ---- ---- - - ' <br /> By;_--------------------------------------------------------------------------------------------------------------------------- --------(Title)-_-_-.__-_---._--_.� <br /> (Plotolan^ showing size of lot, location of system in relation to wells, buildings, etc.. can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATIONACCEPTED BY_V---...----------------------------------------------------------------------------------- DATE,�--�--------- ------------- ----------------------------- <br /> ---`--------------'---'-------`------'----'--'--'--------------------'---- <br /> '-''-'-'-''-'-'''''--''-'''_-''_''''--'---''�----'-_.''--.-'''--''--''_-''-'-_'-'-_-'-'-_-'--'--- <br /> __________________________________________________________________________________�______________ <br /> '--'--'�--'''--''--''--'''-''''-''--'''-''''---''''-'--- ------ ------------- ------- ---- -''---'FINAL INSPECTION BY: '' ^-''-' Date-' o- ' ------'-----/---- ---'-'-''-'--- <br /> SANJOAQU|NLOCAL HEALTH DISTRICT / <br /> /xo so"* Arn°,ic*" Street 300 West c»*k Street /yu Sycamore Street n|* worth ^c" Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br />