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APPLICATION FOR SANITATION PERMIT ^ Permit No. -731-7. <br /> � C�p��+� Date Issuedf- 1- 44'~~^''~'~ 4 <br /> Applica+ion is hereby made to the Son Joaquin Local Heu|H` Distric+ for permit foconstruct and install the work herein described. <br /> This application hmade |n compliance with County Ordinance No. 549. <br /> �k ��K& <br /> JOB ADDRESS AND LOCATION �� ���'���---�.x-.�k�� �� --.--------------.---------.----.. <br /> {]wnnr's Name------------------------------------------- « --------------------------------------------------- Phone------------------------------------ <br /> Address-------------------------------------------------------- <br /> -----.---_.-..A6dmeo_-------_--_--.--.-_----- --------- .----.----_------.------.----.----_-_--' <br /> Contn,ctor'o Name....................... ------------------------------------------------------------------------------------------------------------------ --- Phone__'-_------_ <br /> |mstallation ,ill serve: Residence Apartment House E] Commercial E] Trailer Court E] Motel E] Other E] <br /> Number nfliving units: -------- Number of bedrooms -------- Number of baths -------- Lot size . <br /> Supply: Public system V� Community system E] Private 0 Depth to Water Table -- ft. <br /> �~��^ <br /> Character of soil tom �o of feet: Sand E] Gravel E] Sandy Loam � Clay Loam El Clay El ��o�� Hardpan C] <br /> Previous Made: You 0New Construction: Yes [-] No El ~ <br /> NOV <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted ifpublic sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well------------------Distance from foundation--------------------Material ---------.------- <br /> El No. of compartments-----------------------Size-.._--------------------------- 6ept --------------------------Capacity-._-.—_-.. <br /> Di,posa| Field: Distance from noon,`t weU----- Distance from foundation------------------ to nearest lot line_-._-- <br /> [1 Number of lines'-'''--'' -----------Length of each line------------ -----------------Width of french----------------------------------- <br /> Type of filter mate,iaL--- -------------Depth of filter material..L-.-----Tuf | length---'_'-___'_--. <br /> Saepogm Pit: Distance 10 nearest well —'--''—Distance from foun6ufon ..................Distance to nearest lot line ---_--. <br /> [� beof pits, material SizeD De <br /> --------------------------------- <br /> Cesspool: ot, kDistance from nearest well- Distance from foundation---."..1'2yifll�ll'ining material---q RQ__,Tu <br /> lals <br /> ~�� ^ | r <br /> �� D�t*ncetonenre`+ o+ |i no`--'--'''-�'������--.'-----.'''--''-'_--'--.-'-'—._'''-'-_ <br /> Remodeling and/or repairing (6mszibe):'�' ------------ _'''-'''----_''-__'-_-''-_'__.-_--.__'__-'--_-'-----_ <br /> '—'-----'''--''—'---'-----------'---------'---------'—'----'-----'-------' ' <br /> -------------------------------------------------------- <br /> I hereby certify <br /> that | hred this application andthat the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regul ficins of the San Joaquin Local Health District. <br /> Aff <br /> (Plot plan, showing size-'of lot, location of system in relation to w6ils, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USEONLY � <br /> -----kt <br /> ---------'----------- -------- ----------------------------------'--------- <br />. ` �� 7 <br />' RN�L |NSPE�T{)N BY�--' ��� 'L��' ��»�//»�y~� Du��'--' 3A -��'y '/ '-''__----__ <br /> - �� � <br /> SANJ���U|� bOCALHEALTHD|SRC7 � <br />/ /on s""m American Street 300 West Oak Street oz Sycamore Street .814 North ^C^ Street <br /> Sfock+=, California Lodi. California Manteca. California Tracy, California <br /> sS-9-2M °~.^~°""^ .`_. <br />