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.FOR OFFKE USE <br /> APPLICATION FOR SANITATION PERMIT Petmit No. <br /> (Complete it Dupf'Kaf*I <br /> Date <br /> This Parma Eapeffs 1 Yew Nam Date Iswed kwed �Le..e <br /> App kation is hereby made fo tti! $ar Joaqu n Local Hoath Dn'rict fore permit to constn.ct and inst•4 the rat herein descrbed_ <br /> NNW♦ " T+.s •ppl.cat.on K made :n coompliance w;tft Coun•y Ordnance No. 540. �� 9_ ria- pis 0,W1 <br /> (Jr SSS E I(I1�4✓/F ra ywy� <br /> JOB ADDRESS AND ILLOCATIONI.'?- / fils/ Offws4!tFitTa -...... . !t'.� w+rOwner's Name ./.4 d,t /. ✓ree. .S P�+one /.it ZAdd-ets... . . ... _. ��. .�' ��`OCit'I�ORQ. ..._._....__.__..-- <br /> Ccrl.eceors Nemas./✓.. C c�®NSA L/e'�� PFane. tf. i�.7 <br /> Imfollation will serve: Residence H Apartment Hoare ❑ Ccmmereiel ❑ Tra.la. Court ❑�.yMotel ❑ Othw ❑ <br /> `1'�..car of living units: -.�.._. Nve+bw of bedrooms 7 Number of beths.2%4 Lot sae / .dare-r0 CAC <br /> Water Supply: Public system ❑ Community system 0 Private ® Depth to Waver Took/dO 1It. <br /> Characfw of saT te • dpM of 7 feet: Sand ❑ Gravel ❑ Sandy Loam jo Clay Loom ❑ Clay❑ Adobe❑ Harcipar IES <br /> Previous Appl;c*t;on Made: Of yes.dote 1 No Ij Now Construction: vas X. No [j FHA/VA Yes 1No A <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool Pe^n*'ed if public "wee is &--I I I witb+t 200 feet.l <br /> Sept•c T&4 ]�stence 'r;�m -.rare, we S® r D;staince from fourjotlonLD. *.tater at jJ�r�.aSr <br /> Np. o� comosr+rtlenss S Size.GX./..2M G _igwd deoln .grif " Capaoty x.rZ::i'0 �✓T^,, <br /> D.sp•mal Field: Disseece from nearest we $O i Dstence hom foundetron../�.�. . Dntence to nearest lot fn• <br /> 64 Number o� Gnas__..3 .... ._Length of each 1•n•3S_�7.5—/•M WA6 o' trencF d�"' Y <br /> TV" of fifer materiel �iCjl'X .Dep-h of Ute, mattnalleN Total length 'A00 a +r <br /> Seepage P;t pstanu to nearest .e•1 Ontenc0-It �. ioundatien /p.�..,...D:stence to roarost bt Gne S y <br /> Num..be^ of pits r L;ninq rnIteria St/.��/j� Site: Diameter .11� "� DoP'h . i'.j.S <br /> // <br /> Cesspool: DKtance from neere:f rel .Distance hum Ic•undOtmn Lning <br /> [] Sae: MamaNr Depfh. -Liquid Capacity <br /> Prnry: D:stance from nearesf wel n from nearest b.bdr.g. . <br /> ❑ D.stenre to neatest !at Gro ._.. . ..... . ....._.._. _. '� <br /> Remooel::q end/or ••pa"nq loescriL.O! , �.•��� S y s T G=.0y7•. ._ . <br /> ....... .........:., .. ........ . .. _._.. .. . . .. . _.. / _..._._.._.. ... __. <br /> I Aereby certify that I have orepared this apple&+ion and that the .•ori will be den• in accordance with San Joaquin County <br /> erd:nances. State_la" rules and regul&-ku s of)he So qu�n Local Hvalfh D.strict <br /> ISigradj- - 7 D�✓S� -L/r�- �^�d/o• Ca+n•ctxl <br /> By: z1 <br /> IPIo+ Pon. shoring ti+e of let. Iota+• system in rel•6oft to walk. bulldings, etc_, can be Pi ted *0 ro•ww side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY C S lu/3 SATE <br /> REV EWED BY __ . _ .. DATE.. ... .............. .. ........... ..... <br /> BVI:D NG PERMIT ISSUED _._. . ..... <br /> Aker,/ions amd/a r•ees.smandations: .... ._.._._. .. .. .. _.. ....... .. .._...... <br /> . .... ...... . . .. .. . . . <br /> HNAL rNSPECTION By': De•e <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> IMI a te..r.e as.. lee W...0•k 5+..• 124 S..w...sn..s )os r.n ss ir..ar <br /> *..Aar_GIII..wr t.a. [e1�I.rnm rte-.wa.(.la.rwr rre.r. CaMrwy <br /> t <br />