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� <br /> xn <br /> �APPLICATION ��� ��� � ������ Penn� � .�� <br /> N2 - <br /> k <br /> A��mp�f� �n �up��o�� <br /> ' Dofm Issued ----------------------- <br /> / - " ~ �----�~~~~� <br /> App|ico+ion is hereby made +othe Son Joaquin Locu| Health District for opermit tnconstruct and install the work herein described. <br /> This application ismade incompliance with County Ordinance No. 549- <br /> ' <br /> L J{]G /\D�RE53 N ��� <br /> ! , <br /> . --- <br /> Installation will serve: AApartmentH Co | E] Tm CourtE] MotelE] ��. []Num6e, of |i�nlResidence <br /> units: /-.. Number cf6edroo um6o, of66+hs/, - Lot size - ------------------ <br /> Water <br /> -_-- <br /> Watar Supply: Public_system' 0 CommunHY.sy�om [V Private [I Depth to Water Table <br /> | ' ' <br /> | ���� � �� � mdepth of 3 feet: Sar6E] Gravel E] Sandy Loam E] Clay Loam El Clay E] Adobe Hardpan E] <br /> Previous Application Made: Yes E] No Now Construction: Yes W No n <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: � <br /> (No se��wtank o, cesspool po,mhfoJRpublic sewer � available w�6h` 2O0fwetJ ' <br /> . ^- <br /> Septic tank: Distance from //i No' of <br /> ~~ . -I''_'----------_-~~-' _-. Liquid - <br /> Disposal Field: Disfance' 's�?7g <br /> ---Distance from founclaflond--e------------Distance to nearest lot line--'1-5--------- <br /> Numbe'r'of | <br /> � <br /> ' ------------------------------------------ <br /> Seepage <br /> Ty ' c |fe, mot� � � �� f �' ��..-'Total ' -- �--"---' <br /> --'--7 <br /> ' <br /> Seeougo Pit:' Distance to nearest welL--�-/57V. from _� <br /> Num6erofp�s-.-L-..-`.Uning mu+o�a| �/A���Viomoter-.'�� ..--Depth-�2 �.-._-.-. <br /> Cesspool: ` Distance 6nm �cune�+ we|---_-..Di�an»o6om foundation.----�----�ning muforoL.-----_ .-__ <br /> ^ <br /> Size: D�mef=c� ,--'�.-'_-'''Deo1 '--''''-_'._'''' -----------Liou id Copocity------------------ ---------gals. <br />' Privy- Distance from nearest well ,-''--'--'--'--'_.D�f nca from nearest 6u�J�g---'--'-'________ <br />( �] - Distance-to nearest lot-line-.---.�---_------__--_..=�---_-_-l-----------.-.-. <br />. ~ <br />| ` <br />� <br /> Remodeling and/or n,pm�ring (cle, ribe)­-'-'-''''-'- --------------�-­-------------------- ........_'-- ----------'-______-___-_�____..__' <br />� _---`''__--_--__...__--�_.----_-.--..__._-__--__------_. <br /> � ,_----'----__--.'--_-------_-' <br /> -------_---.--_-__.__...__'-__---_-----'_-____-_____--__-''_.__--___-_-_--' � <br /> '-''-'''_-''''-�!�--'-''-�.'_--__._--___.______.___________.__`_________.__________�� <br /> Lhpared this application and that the work will be done in accordance with San Joaquin County <br /> , (» <br /> ordinances, + <br /> ~ ^ <br /> FOR DEPARTMENT USE ONLY <br /> � (Plot plan, showing size of lo'+, location of system in relation to wells, buildings, etc.. can be placed on reverse side). <br /> An~uCA//um *CCE,|Eo <br /> ^ �'uy <br /> -'-'-'--''-'-''--''-''---'-- ------------ <br /> REVIEWED 8Y_' '_-'' `''--' -----' DATE.'�t-^-- <br /> "---------_- <br /> 8U|LD|NG-PERW|T |33UBD-__--� . ._-.--_----.__---------'_. DATE--Rzw°- <br /> A�a,m+�nsnn6/urrecomnon6atinnu-.--.,._.__----_------_-----.-------.._--------.-.- <br /> ---_-.-`_--' ---'-__---=--'_-�-------_---_-.__-_-.-'_-_--__-_-'-.'_---.'---_---'---_----.-----_----.-_---. <br /> -'_.'- <br /> _' <br /> --------------------------------- ' <br /> -'-'.'--'-'''---''--''--''---''--'''---'--'''-''--'''-'---'------ -- <br /> ' <br /> ----.-'--'-''''------/ <br /> --''---'-''�-�--'-''-_'-'-'''---'_.---'''--'''�-''---''-''----�---''-- <br /> ------__---_-----------__---____ _------------ __---__-----___-----__��--__-----____---_---_---___-----_-_---.__--- ' <br /> ------------------- <br /> |NSPECT0N �� ^ Du+� �� - <br /> ". '='==_,=-^^�. -.------_.. --�^~»'---�---�-�-.'------'_.-- <br /> � � <br /> SANJOAQU|NLOCAL H6ALTHD|�R�T <br /> , . <br />� /ym South American Street | smwm&fOak Street . /zx Sycampre Street mw m"*k ^o^ Street <br /> Stockton, California ` Lodi, California waote=. cakfomia Tracy. California <br />* <br /> ES-9-2M ; n°.;s°d v/u/oo <br />