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\� / ~. <br /> / �� C�N FOR SANITATION _'' y } � / PPermit'No. <br /> PER( <br /> 7y <br /> (Comp � � <br /> lete Dofp |ssued <br /> Applica+ion is 6nre6y made to the Son Joaquin Local HealthD for it U th 0 kk hh ein described, <br /> This application is made in compliaric with County Ordinance No. 549. <br /> 17 <br /> - 7 ca_�Z_ ,(_4 <br />. ' --' ---------------------- <br /> . <br /> -- -' <br /> Contractor's Name_ ��----- \�- ��-^�.l-+--.s��o�3�.�^---.-_-.- P6ono-�Z��-^��^������ <br /> Installation will �me� R���� r�e� H�� � Cpm��� � Te||�, C�� � �u� � O�r � <br /> Number of living units: -t.. Number of bedrooms'..'L_�Number of 6o+hx ..x^.. Lot size ......2'0- ~~~----------------- ------ <br /> Water Supply: Public system [] Community system El Private to Water Table -------- FL <br /> Character mfsoil h, mdepth uf 3foo+: Sand Gravel E] Sandy Loam Clay Loam [] Cloy [] Adobe n6pon [] <br /> Previous Application Made: Ye, [D No 13-11-,New Construction: Yes DQelklu [] <br />� <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool po,m|M*6 | o~eri, available within 200 feet.) <br /> ep,ficnearest <br /> / Dfoundation--/6- <br /> ion- �� Material-d-4. <br /> �Distance from nuousw |Z-.. ---n � �~VNo. of cunnpa,+ment,-�— Liquid 6,pfk,4u . .----.Capacity-/-Z <br /> o�p�o t <br /> v/Z <br /> ------ <br /> __,-_.Distance to re, lot| Field: Distance from | �� Ui � ~? i le `-- <br /> ~ <br />� <br /> Kimber c� |�o�-.���� ' -Length of each Une'���.-/�- Width of �n � <br />� - <br /> Type of �|fnr mofe��|/,'��^��\-�Ueot of �|te, �o1v�o|���������-Totu| �ngth--~��°����..�--.--- <br />' Seepage Pit: LXdaocn to nearest well ----���--.Di��nco fm�� found ut�n_''-.__.-Distance to nearest lot n�--..--_ [� <br /> [] Number b"[ � Lining material Size Diameter Depth- <br /> Coss000l: Distance from nearest well Distance from f,undut/on uomg material <br />| <br /> Privy: Distance from nearest well------------------------- --------- -----------Distance from nearest building-----.. <br /> �] Distnncefonvon,s+ kpt line -------------------------- ---------------- ----------------------------------------------------------------------------------------------- <br /> Remodeling and/or <br /> _____Remo6elingond/ur repairing :-'--'-_--'-'''-'---'-_-_-'--.-________________'__.___-_____ <br /> '__----_._-'--_'-----_----_-__-.--.-_-_--_-___--_-___._--_-_-__-'`___--__.--_'---�� <br /> -''-'-'--_'_'-'-'__----_-'-_'-----'------''___-___.--''-___.-__'--''-__---_'_--------_' <br /> .--------------------'-.-.--_.-_.__--_-'-_-__-__-'--__-_----_.----__.._---_----. ~�n <br /> | hereby certify that | have prepared this application and that the work will be done in accordance irifh San Joaquin County � <br /> o,6|nonoov. State laws, and ,u|ow and regulations ofthe San Joaquin Local Health District. ~�] <br /> By:-------------------------------------------------------------------- --------L' (Title)--- ------------------------ <br /> (Plot Plan, showing size of lot, location of system in rela n to wells, 6uildin4s, etc., can be placed on reverse side). <br /> ' -' --' -T-- '' -- - LY— <br />� <br /> APPLICATION ACCEPTED DY--------------------- -------- . DATE'_ -' <br /> REVIEWED 8Y----_------------- ��-��---.--.--.----- D�T�.-.��!�.--��--'�����.__ <br /> BUILDING PER-MIT |SSUED-_''-''-'--''----------------------------------------------------- D*|t---.-''''-''''_-''-'----- <br /> AKo,a+i6wsund/orr000mmond -� --� _________.__�_________ <br /> _---'���_�_�/�.����/�--.��x�����M�--' -. 'c�._--.---_-_-.--_-'___._ <br /> '------'''--'''''----'----'-''-'-''--'-''-/-''-----'-'----'-'''-------'''-'''-'---''---'-- <br />� ----'---'''-----_''-'-'------.-----'----''-''-`'-''---''--'-'--'---'''_--'-----_--- <br />� --'--''--''----'---''---'--------''--'-'''-'---.',--_-_-----''-''''---_--_.-- <br /> / / <br /> HN/\L |NSPBCT|{}N .. ------------.. Duto----.�--'-�-�-_�_-----'___-' <br /> SAN JOAQUkN LOCAL HEALTH DISTRICT <br /> /mu cv.m American Street 300 West Oak str^°+ oz Sycamore Street ow w"*h "C" Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br />