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/ z_qol ' <br /> FOR OFFICE— USE- ' �L <br /> Permit N� -����''� <br /> ��`������U��� ������� <br /> ' -- �������������� p��|� ' --' <br /> ^' SANITATION - �_i, < <br /> APPLICATION- �� -\ ~ <br /> --- Date Issued _----------------- <br /> ----------------------------- <br /> r From Dat ls�'iued <br /> ' permit to and install the work herein described. <br /> m� � t� � Joaquin Local Health0��d �, u - <br /> Application is hereby <br /> This application is made in compliance with County�Q�rdiiance No. 5 9. <br /> Contractor's Name-------------- -- artment__Hous-e--El----Com-mer-c-ial T railer Court C1 motel C] Other [I <br /> Installation will serve: Residence s J.- Number of bath� O'Z.. Lot size / ------------------------------ <br /> Number of living units: ---/___ Number of bedroom eY� <br /> Water Supply: Public system 171 Community system 9KP'_11vat9 F1 Depth to Water Table <br /> Character of soil to a depth of 3 feet: Sand F1 Grove[ n Sandy Loam El Clay Loam D Clay E] Adobe g3--Rardpan [_1 <br /> Previous Application Made: jif yes,date----------- No M New Construction: Yes E] No [I FHA/VA: Yes No El <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic +a-n-k--or cesspool permitted if public sewer is available wit in 200 feet) OF <br /> "Y' Distance from nearest w -Distance from fo%pdation--- - ---------- <br /> Disposal Field- Distance from nearest well----7rf��._Distance from foundation--/ <br /> ^ - ---'�'- *�- <br /> Typa of filter matohu| a6u*prn of filter " ~'~'~ ~w~ <br /> Seepage P�' I�unco +� nearest of�n_- nearest <br /> | -/-,.,p�=~ <br /> - <br /> Distanc <br /> bm� Number of Lining m�eriu\ I|zc' D\ume+e -�----- <br /> Lining mo+n�a| ' --'—--~*-~~' <br /> - <br /> Obt nce from nearest �e�|' '--O�tonxn from {oum6o��n <br /> Cesspool: -''�'--L�uid Capacity <br /> - ��«: ��mrfer--'''-_'''-'' -'_Dep+*---'-----.- <br /> �*nce from nearest |�ing . ''-'--_.-'''- <br /> . <br /> ~� <br /> p�vy^~- Distance from nearest well <br /> n.�-_--...�---------Di - __________ <br /> __�___ <br /> p �t6 <br /> -'' ----------- <br /> --------- <br /> | <br /> Remodeling and/or repairing �eo nb�:-_-.,^����°_� -- _.~ -----------------------_-_-__-''_-''--�-`''-''-__-----_.--'-� -_.'_--__.. _-..___.--__.-_--_-'__-'---''-''-''''- <br /> . '-'--_.----'''-''--__.'__�''-_--'--_- --' ----------------------------------------- <br /> 6� 6�n� � a���r6an�� ��h San County <br /> -'----'--� n,� th� n6 t6afrn= �mr ~..,--. <br /> ' H,af | heva app/�o,m" " . '- -- --' <br /> / xar�myu*nxY rules p~r~``~ ''- of the San Joaquin Loc Health District. <br /> ordinances, State laws, and <br /> | <br /> (Plot plan, showing size of lot, locaflon of systee relation to wells, buildings, etc., can be placed on reve <br /> . ~ ~O° =. ..`.`_' <br /> T USE ONLY <br /> � Alto,mti*no and/or recommendations:---------------------------- <br /> ------------------------ <br /> --------------- <br /> ' FIN/\L INSPECTION <br /> ' . <br /> SAN JOAQU\NLOCAL HEALTH DISTRICT <br /> »uuwest oak Street�. *w""�"°�m� 205 West <br /> �vmm�. <br /> ' <br /> 1onm,,mAmerican�="t ~ � ` ` r,",v.California <br /> Stockton,California Lodi,Cc Manteca,California <br /> =."°=°"=°.""�F."o,,= ~"" <br />