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iA f.- �, <br />~�� �� <br />~,�- <br />/ � Vj <br />Ap�\ FOR SANITATION PERMITu <br />(Complete in Duplicate) <br />' Application is hereby made to 11ne San Joaquin Local Health District for a permitfnconstruct and install the work herein described. <br />This application is made in compliance with Count inare�'No. 54,9. <br />JOB ADDRESS %L ------- ----------- ------ --------- <br />Installation will serve: Residence Apartment House [:3 Commercial E] Trailer Court El Motel 0 <br />Water Supply: Public system Community system F1 Private Fj <br />V MM/ClayLoamE] ClayEj AdobeE] HardpanE] <br />Characterof soil toa depth of 3 feet: SandEl Grave[F] SandyLoa <br />TYPE OF INSTALLATION AND SPECIFICATIONS: <br />(No septic tank or cesspool permitted if public sewer is available within 200 feet.) 1 10 <br />ID <br />Septic ank: Distance from nearest well ------- Distance . 4unclafi ------ iquid depth -------- ---------------- <br />Cesspool: Distance from nearest well ----------------- Distance from foundation ------------------- .1-ining material <br />Elnearest lot line | est lot onv`___-. <br />� Pit: Distance to nearest well Distance from foundation -D�fonc�to naun^ <br />ze: <br />6 <br />Li 4- <br />65 r <br />----------------- <br />from foundafi< - Diifance to nearest lot <br />l- <br />�.- <br />. <br />_____�_-_ <br />n' <br />__.__ <br />____._�___. <br />Remo6��g and/or repairing �eoc�b�:''�----'-�''__._-'-_______________ <br />--�--'-'--------------------------------------------------------------------'- <br />----------''--''-'---'----�--'---------------------------------------- <br />----- <br />—'--' <br />her <br />-----'---fy -�-and rules and regullions -'- '-----------�---\h-6 fh� -�U anGon and that buildings, etc.. must be filed with this application). <br />the work will be done haccordance w�h San Joaquin County <br />in Local Health District. <br />0 --------------- (Title) ------------ <br />T USE ONLY <br />D VVY�'''---'- DATE--- <br />-- <br />��-------- <br />IT*. <br />REVIEWED 8'' --''---------— DATE _---''��------'---__ <br />BU|LD|NG PERMIT ISSUED ''---f +he San ------------------------ relation to OR �-'''-�''�--- <br />------._-�---'_.-�� ��---------------- <br />-------------------------------------_--.�TDN <br />pERM|T Nv_ ^�^J- ISSUED F~ ---_.|Do+� FINAL |NSPB <br />Date ''''---.'�fv--7-',�r-------------------------------- <br />SAN <br />'_-.'-'-'-_. <br />~ <br />- <br />SAN�OAQU|NbOCALHEA�H DISTRICT <br />130 South American Street <br />Stockton, California <br />ES -9-2M 9-50 <br />