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<br /> :R OFFICE USE:
<br /> APPLICATION FOR SANITATION PERMIT Permit No. ..../...�' djf_
<br /> t (Complero in f'uplicato)
<br /> This Pori-nit Expires 1 Year From D t_o Issued Date Issued .d//.� .L...
<br /> Appli;:rt,on is h reby made to the Sart Joaquin Locnl He•-nIth Du+rict for a per, t to construct and instal;tho work herein described.
<br /> This a;,pliration Is �:ndr, in con•,pliance with Cour y Crdinancrr No, Soy. C ,
<br /> r .. !Of3 ADDP,FSS AND LLMC AT!CN '... l F'_ ,,': n l- l.. IG. .!J7.,L.t. - ._ ...J7.
<br /> Cane- , Hamr•. l C t- . .. _.raj-;I r.?(' X': (1 T F Phone ......... ..
<br /> • Addre:
<br /> E. �.,
<br /> Contractor's iJam;:r. C. hf,rN. _ Phone............................. ....
<br /> installotion will servn: Residence F] /Npal,tmenf House ❑ ':armrner,wial ❑ Trw;ier Covrt ❑ /Motel 0 Other ❑
<br /> uc �z Number bat' /. . Lot sire - .vJC Jr'r
<br /> Number of Irvirq units: l Num r n! )oJro,rrs 1 or 1.s //
<br /> Water Supply: PubL: system ❑ Cornrr,urity sysf+gym [jPrivate [! Deptr to Water Table 7,0, ft.
<br /> a i Characier of soil to a de,31th if 3 feat: San, (j (.-rival L] S9ndy Loam El (;lay Loam (T;''Clay❑ Adobe❑ Hardr)an [I
<br /> Previous Application Mede: lit yes,cJcts= ' Nok
<br /> New Consfru_!;on: Yes ❑ No (]jam FHA%VA: Yes 7j, No EL'
<br /> TYPF OF INSTALLATION AND SPECIW_-ATIONS:
<br /> (No septic tan;: or cesspool pe.miffed .f pulalic sewer is ava;lable within 200 feet.)
<br /> unpt:. `vit .-.t,+.u: n:r „,r: Distance from foun,,1: on -. Material _..
<br /> depth (;anacity
<br /> t,n ri lrr,rn nc roEt v.r.' t"+( w D !rncc ant uunr n: f Branco to nearest lot line_ .-.. .. .-
<br /> Xl.rt 11
<br /> 1 nI G 1 n o r n h I I _ b�':rlth of trench `
<br /> ,rru, a; limn 1
<br /> (1 !' Iter n f •'tial 1\,Cc Total length '_• . . ._.
<br /> �
<br /> ftr nc c., w.:'. Dist;;ncc! iron toon nt- >n .1�istance In ncnnrest lot lira
<br /> ..
<br /> [J L af,. a1 fan^ra*ii.• Depth
<br /> r
<br /> n Di '3r Cc ir, T, +c., 1.1 1+ Lining m.Oierial -
<br /> i C�cr fr. I_;q„;d CdGaCity gals. ,
<br /> Privy: ; , _ 'ro' . , ;�•. ,, ..
<br /> Fl;, . ,,.r; from ncarest build;nq
<br /> I i'o.—by cert;fy ti,it Z h.7ve pr,-pared in:; a;npl;caf on and th.:lt tha work will be done in accordance wish San Joaquin County
<br /> ordina,•ct;,,Stafrlaws, or.rf r•tie5 a§nd rc:aui.iiions r•F thr San Jt:>,'rriu,r Lacy
<br /> I He,lth District.
<br /> { (O-�ncr and/or Contractor)
<br /> By: (Title)
<br /> (Plof plan, showing size• ,,f lot. local; of ',y,,trrn in 1c,Iaf;on to wells, bu;ldinys, tc•. c.in be placed on reverse side).
<br /> FOR DEPARTMENT USE CNL
<br /> I i , p,n 1 E : • f, { r,
<br /> f.4lfcrafl_.-,+ and;.�r n.cem^„ ncfaf;<+rs:
<br /> „ilALiN C
<br /> j1601 E Kor•uo,.A.. .., ,. , .• _ ,. i.
<br /> a
<br /> ENVIRONMENTAL HEALT"EPARTMENT
<br /> SAN JOAQUIN COUNTY
<br /> �.
<br /> 5'.---�C�'•9 Unit Supervisors
<br /> 2 .G
<br /> e ; s ?, Donna K.Heran,R.E.H.S. Carl Borgman,R.E.H.S.
<br /> UX < Director 304 East Weber Avenue, Third Floor Mike Huggins,R.E.H.S.,R.D.I.
<br /> Al Olsen,R.E.H.S. Stockton, California 95202 Douglas W.Wilson,R.E.H.S.
<br /> • �•., P• Program Manager Telephone: (209) 468-3420 Margaret Lagorio,R.E.H.S.
<br /> Laurie A.Cotulla,R.E.H.S. Fax: (209) 464-0138 Robert McClellan,R.E.H.S.
<br /> Program Manager Mark Barcellos,R.E.H.S.
<br /> MEMORANDUM o
<br /> DATE: 2 l 13
<br /> TO: Chuck Farrano, Counter Manager
<br /> Community Development Department
<br /> FROM: Mike Huggins, Supervisor R.E.H.S.,R.D.I.
<br /> Environmental Health Department
<br /> RE: �1 �f � I E . T- �(& � hoc rm
<br /> Site Address
<br /> Land Use Application or Facility Name(if applicable)
<br /> The San Joaquin County Environmental Health Department has reviewed the above referenced
<br /> application and applicant has met all our conditions. Please release building permit(s) for
<br /> construction. (�
<br /> If you have any questions, please contact my staff person, <,
<br /> Registered Environmental Health Specialist at(209)468-
<br /> Comments:
<br /> EH 7/11/01 BuilclPermRel
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