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FOR SANITATION APPLICATION SAN|TAT[ON PERMIT <br /> (Complete in Duplicate) <br /> Application is hereby / <br /> made to the San Joaquin Local Health <br /> This application ;s made |n comp|�n� �rct for m permit toconstructmn� ins�U�o�� �e�/n �� eo. <br /> �nn ��«n�y \�r�moncm No. 549. described, <br /> JOB ADDRESS <br /> Installation will serve: Residence 9-`�A_parfmenf House E] Commercial 0 Trailer Court E] Motel [:] Other <br /> Number of living units. -1 Number of bedrooms Z Number of baths El Lot size------I---- <br /> Water Supply: Public system 2--communify system E] Private E] or ------0---------------- --------��%. <br /> Character of soil to a depth of 3 feet: Sand El Gravel [] Sandy Loam iay cam dobeA _Ha_rcl�ppan <br /> i - E�4 Clay A <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No Septic tank or cesspool permitted if Public sewer is available within 200 feet.) <br /> Septic Tank: 75 <br /> Distance from nearest well-----------------Distance from foundation--------------------Material <br /> `~=",p""/: Distance from nearest woU-_'_-_-Distance from foundation Lining.--Liquid| ''---------'' <br /> LJ Size: D�mefec_---_--�-----__-Depth___________._-------� n »g �o�»no-'-------'-----0 <br /> p,�y Distance from nsm�s^ *m �---'— ~� ~^ <br /> D�tonce +one�ru, ~ '^-''�^�-n«'s��''--''--D�+o»ca from nearest6uU6�lot fineg__. �^------------------------ ) <br /> Seepage Pit: Distance to neares+"well----------------------Distance from foundation-------------------Distance to nearest lot fine <br /> -------------- <br /> -Disposal Field: Distance from nea'resf well------------------Distance from foundation--------------- ----Distance to nearest lot line-- <br /> Type of filter mate"rial-------------------------Depth of filter material <br /> ----------- <br /> -------------------------------------------- <br /> I hereby certify that I have prepared this application and fhaf_fh­e__w_o_rk­_wi_1l__be_-don-e--in_`a`ccorda`nc`e_-with-S-an--Joaquin--Cou-n <br /> ordinances, State laws, and rules and"regulations of the San Joaquin Local Health District. <br /> (Plot plans, showing size of lot, locatioWof system in relation to wells, buildings, efc., must be filed with this application). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY----- <br /> ~".^D",`, ,Enm// ISSUED---------4012 DATE—''-��^ '--_-.-- <br /> Al+e M �-''--------'---- ' DATE_ 4 <br /> Date <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> 130 South American Street <br />.~ sS--9-2w v'xo vv�/am �f�mk� . California ^ <br /> ` Stockton, ' <br />