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, . <br /> (Complete in Duplicate) -Ij <br /> Date Issued <br /> is hereby.made to the- 3a Local' <br /> oca Health Dfor a permit to construct and install the work herein described. <br /> 's application is made in compliance with County Ordinance o-. 549. <br /> JOB ADDRESS XND L�FATI AO' <br /> Installation will serve: Reside" 8� Apartment House E] Commercial El Trailer Court E] Motel-[] Other El <br /> Number of living units: --- Number of bedrooms *2___ Number of baths ---/__ Lot size __ I <br /> Water Supply: Public system Com-munity system E] Private E] Depth to Wafer Tablec ft. <br /> Character of soil to a of N3eef: Sand E] Gravel E] Sandy Loam E] Clay Loam E] Clay D Aclob Hardpan <br /> Previous Application ~'~~~' '"~ E] '`" '`=" C""urux'/vn: /u� � No <br /> ' <br /> TYPE OF INSTALLATIONAND SPECIFICATIONS: <br /> (No septic tank ' <br /> LengthSeptic Ta4: Distance from nearest <br /> Xs+ance from foundation-- ---------Matey ------------ <br /> Disposal Field: Distance from nearest well------------------Distance from.foundation---------------------Distance to nearest lot line----------------- <br /> ' -_Width of trench ~-� <br /> Seepage Pit: Distance to nearest Distance f7m 'founytbfionl/_ ,4��----------Distance to nearest lol line—:5— <br /> Number of pifs----- Lining materi <br /> _ ' , <br /> F� `'^~ ~'~^ e'~' ""r'` Liquid Capacity' _'gu ~ <br /> �elmocleli'rig and/or repairing (describe):----------- <br /> hereby <br /> oMinances, Stat9450's, and regulations of the San Joaquin Locaf Aeaith District. <br /> io <br /> ow, size f 0 <br /> jll�lot plan, showi siz of lo , location of system in relation to wells, 6uildings, etc.; can be ph --;r <br /> O� d-wo _v <br /> FOR DEPARTMENT USE ONLY <br /> kB8EVVED ' <br /> BUILDING PERMIT ISSUED '__.'------------------------------------------------ ' <br /> AKerufionsmn6/or ,ecnmm�mJufionn:----------------------------------------------------- -------------------------------------------------------------?.___._-.__..______ <br /> -------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------- <br /> ------------------------ -------------------------------------------------------------------------------------------- -._.---..__.--_-_-'__.----.__..___-__.--- <br /> ---------------------------- <br /> -------------------------'--_.''-_.'-__.''-_--------_-_-'_----------�-_--.__-_.~=_-__._-- �- <br /> , . . <br /> -'--_,�''--'-_-- -------------------- ----------------------------------------------------------------------------------- <br /> � <br /> ' <br /> �' <br /> FINAL :'INSPECTION BY 41W <br /> .. Date- ._.��----��-�� ------..__...-..__ ' <br /> ' SANJOAQ0N LOCAL HEALTH DISTRICT <br /> /m South American $rem 300 West mak Sfree+ /32 Sycamore Street 814 North "C" Street ~ <br /> Stockton, California Lodi, California Manteca. California n=vv. California <br /> eS-/9-2w 8-5/ a°.u°avv-Mo' - <br /> � �� <br />