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APPLICATION FOR SANITATION PERMIT Permit No. <br /> %Cmmo� <br /> f� �m Duplicate) <br /> ' ` Date Issued —./�.---{------Application is . <br /> ' � 1 ^ <br /> nne6vmmJo�ntheSanJooqu|nLoco| HuuHhQi�Hctfo�op*rmitfocons�uc+ un6indnUt6&°or herein described. <br /> This application is made in C6mpliancowith County Ordinance <br /> No. 549. <br /> -1 2387 E8'st � �������.�JC8ADDRESSAND LOCATION-_—._—...�._-'__. <br /> ^ ! L � ^---_^--'-f�� <br /> ------------------------`--' <br /> '—_____} <br /> _—. <br /> - . <br /> Installation will serve: t.Re-sidence [] Apartment House' Co��merciail E] Irailer 4W Motel E] Other E] <br /> Wafer Supply:-Public sysfe�n Private E] Dep <br /> Character of soil'to a a feet: Sa�ncl Gravel E] Sandy Loam CJay'Loam [] Clay E] Adobe [Z Hardpan El <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> eptic Tank: Distance,�o '�yt | z��z�� -ance fro �u^ cc brick' <br /> D;sposal Field: Dis�ance'from nearest weII_,a!QmJDi'5fan e fro f o -__Zal------'Distance to n'earest lot line-5------------- <br /> e----- Width of french. <br /> Number'of iines--- Length of each fin 40 ---24 <br /> Seepage Pit: Disfanc�."f�_�Eigresf well DiitgTce_frorr�foLi�cl'fl n--. <br /> i me <br /> Cnopoo|: Distonoe"frum nearest well '�Disf ncefrom t�un�q/i�z����_1���Lining moteriaL—.---`---'--'--_—'— <br /> , <br /> Remo"el/ng onn/v, repomny,rp�/���' —'�----- --------------------------- <br /> 9 --' <br /> ,' —��''-'''-----�''__.' ���' --_—'_—.'--'—_--'' <br /> -__._--_---_'--._—__—.�---__.^--�~_---�--'_—_----'_---_—__--..___---___.—..+--' <br /> ' . � � , ' <br /> _�''—''--'—_'--_�—''—_.'--`�`'----_--'__'—_.'_____-'--_—'—__-'—__.'—''_'''___'_---''—''—`--' <br />� --------_----_-�-�^'-�-�.—_.-'_---_—.—'''_�_'---� --- __. '� ------------------------------ ' <br /> . '' '- ''' ----''_''--'- ' � <br />| I�here6y certify that I kave.prejra�ed this application and that the work will.6e done in- accordance with San Joaquin County <br /> ordinances, State laws, and fules and regulafions'.of Ae, San Joaquin 'Local Health District. <br /> Sons ,.;— <br /> (Signed)------------------------------------------------------ ------------------- - -;-------_---------------. -------------------------------------------------(Owner and/or Contractor) <br /> ` ^ `-----------------------Fif lei `Y\ � <br /> (Plot plan, showing size of lotjocati6n of system Jri relation�fo wells, 6uildings, efc., can 6e placed on reverse side). <br /> . "O~ "=,"=°"=". "S=^'NL. . <br /> ' ----------------------- <br /> /,� ' <br /> REVIEWEDBY.'''--'---'----_'.�—'—''''—'------------------ ------------------�!''--'''—''' DATE------------------- '—_.'_—'_—__.___ <br />� BU|LD|NG PERMIT |SSUEO_-a--------------------------------------------------------------------------------------------------- <br /> DATE.—_.�_'--._--_—_ _`___ <br /> A�e,mmon nu/ . _-__—___---____.—__--_--_.�__ __ <br /> ��- - '—_''''--.—_.'__—_ '_�`--'— <br /> '----' — ------------------------- <br /> ------------------------------- <br /> -------- <br /> .� <br /> . <br /> -----'—_' "]NJ-I%- . ''---''--�-''—'''—''—'''''_—�'`--'—'—'_—''---- <br /> `. '—''—~ '—'—''--'—'''—'^' '` — .' <br /> ——''^' <br /> '—`''� '°'�—�—'~~'�''�_� <br /> .—''--''—'—''—''--''—' <br /> �NAL |NSPECTD <br /> Date'—,=��''������~r ' �7=`--.'—'-------''—' <br /> ~ <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> ~ <br /> /30 south American street 300Was+ Oak Street /32 Sycamore Street m* North "C" Street <br /> Stockton, California Lodi, California Manteca, California ?racy. California <br /> ES-9-2M Revised 1'57 ppco ' <br /> '. ' . <br />