Laserfiche WebLink
° APPLICATION fOR SANITATION PERMIT Permit No. <br /> (Complete in Duplicate) / <br /> ' Date Issued <br /> T� o San Joaquin Local Health Dist� for� u permit to construct and /n,tzUthe' - herein �o,-�---' <br /> /no application is mode in compliance � � County Ordinance N 549 - - <br /> JOB ADDRESS AND L'QCATION <br />. <br /> Owner's .,.... <br /> Installation will serve: Residence Apartment House E] Commercial El Trailer Court 13 Motel El Other El <br /> Number of living units: /----- Number of bedrooms 5L_ Number of baths /---- Lot size -------- <br /> Wafer Supply: Public system ' Community system [] Private Ej Depth to Water Table J�?ft. <br />� wnmnac=, of soil n, m depth of 3 v�� Sand LJ ��mve| LJ Sandy LoomLJ C�y Loum [] ClayE] A6o6o/^^�� Hor6pmn [feet:I � <br />` <br /> Previous Application K4md*: �Yus O! No [K* New Construction: Yes E] No ��� <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> /No septic tank or cesspool ~ rm�te6'� public sewer is available within 200 feet.) <br />. � . <br />^ Soptic'T k o from noures+ weU_-----Distance from fouq�otion-------Wu+eriuL.--_-_. <br />� [� -�6��Fconnpurh�on�----'''-'Gro'__.''''-'''._Uou@ �oof -'_--' Cun�c�v'---'-- <br /> ' | ' '� --Capacity ` <br /> Disposa| Field. from nearest well '' --'-Distanco from foundation--------------------Distance to nearest lot line-'_._.. <br />. [] uJ |in=,i---------- -------------Length of each line------------------------------Width of french--------- ------------------------- <br /> ' Tynffilter mat���L.!.--.--_.Dpu+ of �|fo, mofu6o|-._----�Tot | |onot�--'-''''-'--'-'''' <br /> ­ <br /> Seepage Pit: Distance fo - '��� / <br /> � well-. °'^. <br /> _ ~.. from.~'.~...~ .~ . noonsrlot / �^ <br /> 5L Number ofpits !- /-------------Lining mate ria L,��`{� |ometer'- Dvu+�-' <br /> . <br /> --------------- <br /> Cesspool: Distance from neon,�.wmU----_Disunoo �nm'{vun6at�m--------Lining mufohaL-------____ <br /> [l Size: Diameter------------------------------_'-Doo+6 '--.`-''''-_'''--'''-/`'Uoui6 Capaci <br /> fy ----'---__ga|s. | <br />' Privy. Distance from nearest well---- -----------------------------------_Distanco from nearest building <br /> Ll Distance to nearest lot line-- -_''-''----'''-''''-�__'-_''__---__--_________________ <br /> Remo6�|ng and/or repairing (Jmc�ba)�'�-�-_-'''-''- '---''_-''-_�.-_-''-_'__.'_-'-'-'_-'-'___-_.____ <br /> '_.___'_-__----.-__----_-'-�_-_---_.-..__-.-'_--__.__._-_-._-_---_-''---''----'�-'_--' � <br /> '--'----'_'''----'-_-��--_-.''-------__---'---'----_-__.___'----'________--.._-''___-____--- - <br /> .-'�-'''''''--_'--''-'-''-'-''---'-_.'-__.''__.`-,-''-_-'-_.-'-_.''''_''_-.-'_-__'--'-''-_-'-'-- <br /> hereby <br /> ordinances, St e la s and rules an-cd re ulations of the San Joaquin Local Health District. <br /> (Si�w�~+- + �4 ' � �� ----- <br /> � <br />' ��' '----- and/or � <br /> '-� .-~_.^ ----------- --------_-�.^°°' <br /> (Plot plan, showing size of [of. location of system in relation to wells. buildings, etc., can be placed on reverse side). ~� <br /> ' <br /> FOR DEPARTMENT USE ONLY <br /> REY|E�/ED 0L � <br /> ��71�s ----------- ------ <br /> ------------------- <br /> -- <br /> --''- _^ ------------ <br /> --- <br /> '���- �^��­-----------�-°-�----,-^-�_--�.-�.--- <br /> -���______. <br /> '--- ---------^='--------\'+-----'------ -----------'---------'----` <br /> '''''.-'--''_''_'''' ' -'-' - _-''--. <br /> RM/ L <br /> INSPECTION 8Y:--. --..._--.----.. Date-- �[ .-~.-------------.-_._--- ~ / <br /> | <br /> � <br /> , SAN JOAQUIN LOCAL HEALTH DISTRICT � <br /> 130 South American Street ' 300 West Oak Street /32 Sycamore Street 814 North "C" Street <br /> | <br /> oto"m"" California , 4d\ o°kfo=ia Manteca, California Tm*v California " <br /> =_°_`" 145446AT="", .2-54 <br />