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APPLICATION FOR SANITATION PERMIT Perm." N <br /> (Complete in Duplicate) <br /> ~K Uu+o |s,ued�7--/,6/­<^ <br /> y <br /> is hereby mo6o to the Sun Joaquin Local Hoo|t6 District for o permit to construct and install m �the ^m,k 6e � described. <br /> This application is made icompliance withOr6N 5 <br /> '----'-- <br /> _ <br /> Owner's '`==` <br /> A66reo------------------- <br /> Contractor's Name----------- __------.-------''---_--'--- Phone----------------''____- <br /> |nstu|latio will serve: Residence Apartment House [:1 Commercial 0 Tai|o, Court F-1 Motel [] <br /> Number ofliving units. %-^~N bof bedrooms 1` Number of 6oH`, size -- -��.-/ ^���. [' --' <br /> � <br /> #afSupply: Public system ;�'CommunHy system 0 Private M Depth to Wafer Table -- ft <br /> Character of soil to u depth of feet: 3nn6 E] Gravel E] Sandy Loam D Clay Loam [] Clay [] AJo6e [�--���,6pvn [] <br /> Previous Application Made: Ye, E] No ° Construction: Yesj�c;-[] <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank o, cesspool permitted if public sewer i, available within 200 {vet) , <br /> ^L <br /> - 5o Tank: Distance from U 4L / j� <br /> No. of compartments �� S - Liquid d.e pth C / <br /> Dispom| Field: Distance from nearest weU'06 -I.-t-Distance from foundation --,Pis+onco to nearest lot <br /> - ^ line <br /> ---- <br /> Number of lines---. Length of each |inQ2-5�7( �[-mi6+k offrench--�� ,'.q � / �� <br /> --------------- <br /> Type <br /> Typo of filter mo+o,ini � -- � -�--_^- <br /> 3eepogoDistance <br /> Pit: D�,fonco +o nnvn`s+ ��L���>�s�.� D + co f fou 6 fi _��l]�� to | | <br /> ----- <br /> Number of pits---/---'Lininq material--- Size: Diumv+ec._ Depth--..�� <br /> : Distance from nearest well-'---'Distance from 6mndotion --- --------------Lining materioL---_--_---- <br /> F-I Size: Diametec ------------------- -------- ------Depth--------- ------- ---------------------- -----------Liquid Capacity- ---------------------- <br /> `~ <br /> Privy: Distance from nearest well _- --------------------------------- ---Distance from nearest building------------------------------------------ <br /> F] <br /> " <br /> ------------------------ <br /> Remodeling /or repairing ( . <br /> I hereby certify 11 �ave prepared fhi application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State law"nd rules and relgulations of the San Jloaquin Loc;�I�Hea/ll h Disfricf. <br /> (Plot plan, showing size of lot, location of system in relafion to wells, buildings, efc., can be placed on reverse side). <br /> - FOR DEPARTMENT USE ONLY <br /> ------------ <br /> BUILDINGPERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE.__.-__-_-____-___._ <br /> Alterations and/or mcommencla6o��__-__._____ _ <br /> .~ ---------- -------------- --------- -----------------------------------------------------------------------------------------------------------------_-______--___.._- <br /> ---------------- -------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> -------------------------------------'------ .................................................................................................................................................. ------------- <br /> ------------------------------------------------------------- -._-----'---_-'_--------_-'----.-_---_--_-_-__ <br /> /� <br /> FINAL INSPECTION 8Y:-/-'�=����--' ---- Dn+o-- --.----- <br /> S/\N JOAQU|N LOCAL HEALTH DISTRICT <br /> /m s""m American Street 300 West o"k St,"a 132 Sy""m"," Street ow North "C" Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California ' <br /> _ <br /> ES-9-2M Revised vv-2/uo <br />