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• A <br /> APPLICATION FOR SANITATION PERMIT Permit No. .......... I. 7.. <br /> (Canter in Duplicate) <br /> This Perrait Expires 1 Year From Date Issued Data Issued ...`.//..,.:=..y... <br /> on it hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> 'cation is meds in compliance with County O.dinance No. 549. <br /> DRESS AND LOCATION........],24$. M,Orlrpsaio9d �tnektr <br /> .........................._.......... ............................................................... <br /> Name..........Pati..-S.U.QY........ ....rr.�.!?,..rr.°...crane, Service........................................... <br /> . . „ one........h........':.. <br /> .rt2...^ti.......... <br /> ......................$nInn._ ..........._.............................................._.........................._........................... <br /> xs Name.....! e.. rY.� Z�IST...�.f•.Rr1"CPhone...I.: <br /> I <br /> F <br /> .n WIN verve: ResidenceA <br /> (� <br /> Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ or, U <br /> smber of living units: .. 1. Numbe;of bedrooms...,2.. Number of baths A... Lot size ....3....ac 4 <br /> . ............................................. <br /> IPp : Public system Q Community system ❑ Private MX Depth to Water Table .501 ft. <br /> r of so0 to a depth of i feet: Sand 0 Gravel❑ Sandy .oam[J Clay Loom❑ Clay❑ A lobe Qj HardC3>PPlicafion Made: Ys s Q No LJ New Construction: Yes [3No I,]t( fHA/VAI YesQ No[I Hard <br /> INSTALLATION AND SPECIFICATIONS: <br /> o sePtic tank OF enspoal Permitted N Public sower is available within 200 feet.) <br /> �nk: Dist-nca from nearest well..... ........ ..Distance from foundation...................Material......... ............... <br /> tinyNo. of comportments..........................Size.. ....................... <br /> ..............................Liquid depth........................Capacity......_.._.. .__... <br /> =ield: Distance from r•+rest well.....5j0!......Distance from foundation...1W........Distance to nearest lot line..cio 1........ <br /> i np Number of lines......I..........................Length of each line........50!..............Width of trench.........?N..t.................. <br /> Type of filter meferial..S.Bp....F{)L..Depth of filter material....la"...........Tote) length.........KQ�......................... \ <br /> Pit: Distance to nearest wali.....1�!......Listance Irom foundation...3.Q.�........Distance le length <br /> nearest lot ..no..... <br /> Number of pih.l............. ...Lining metareL..F10Ck........Size; Diameter._.....�.�'.'. _ Depth . .2,5. �l <br /> Dist <br /> Size: <br /> from nearest wolf... .. ...............Dit}inca from foundation. . ...............Lining materiel.. _ .. .. . <br /> . ................. <br /> ist ce toter................. .. ...............Depth....................................................Liquid Capacity..........................gals. <br /> Distance from nearest well.........._................................. .Distance from nearest building.. ....... <br /> Distance to nearest lot line__............................_........... .. - - <br /> _........................................................................_..._ <br /> igand/or repairing (describu):..................... ........................................................................ ...................................................... <br /> __........................................... ....."..UF.'FL`: '. i:.TAP..Y..D.UI;JA.U.........._.......... ....... .. <br /> ........................... -. . . <br /> . . .. .. ......... .... .................................... <br /> ....................... <br /> ..:.... . ....... .................... . .....:. . .. . . <br /> 16y car,.,1 that I have prepared this application and that} wor..k..will be done in accordan.ca.... ..... <br /> with S.an Joaquin County <br /> S. State laws, a„d rules and regulations of the San Joe In al Health istrid, <br /> 'he...u1:Y..k:.: T ':. ....a.t.p.ti�...:°�..^_M...S.e^V1.f E... act <br /> Cc <br /> .............._.................I................... ._... :. ... _./i �5.r�..._(Tifle).. ....__ . ..(q I <br /> / Cc <br /> 1 showing size of let, location of system in relation to wd , buifdfrio. at can be piacion ravr]— erre side), (� <br /> FOR DEPARTMENT USE ONLY — 1'V <br /> — — <br /> TION ACCEP'(EO BY .... ... DATE......... <br /> D BY.. <br /> ...................... ..... DATE................. <br /> s PERMIT ISSUED .. ”' - — <br /> _........... ........................ DATE................. ......... <br /> .. ..... .. . ......... . <br /> < n or recommendations:_ _. . .__ . <br /> n <br /> NSPECTIOII BY: /�1.j'1\ Date- . <br /> SAN JOAQUIN LOC,+L HEALTH DISTRICT <br /> .dA Amolcan Straat 700 Wut O.k Sheet 112 Svc..*" Shoat ate North "C" Sind <br /> .ubn. C.rldoni. Lodi, Cdifornia Manteca. Cdifarnla Tracy, Cdllornia <br />