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– /\Y7^L\C/\T|ON FOR SANITATION pERMr Permit No. <br /> (Complete DupK�u�� <br /> ` Date |ouo6 <br /> – App|ico�on is hereby mu6v to the Son Joaquin Local Health District for u permit +oconstruct and install the work herein described. <br /> This application i, mo6o in compliance with County Ordinance No. 3+9. <br /> Owner's N <br /> AA <br /> - ------------------ <br /> ----------------- <br /> Installation will serve: Residence F0_1 Apa 'tment House Commercial 0 Trailer Court El Mot j Other <br /> Number of living unif��- __ Number of bedrooms Number of baths _�---- Lot size ------ IL <br /> Community system D Private afer Table <br /> Wafer Supply: Public system 0 Depth to W <br /> Character of soil to a depth of 3 feet: Sand E] Gravel Ej Sandy Loam L] Clay Loam E] �Iay fl� Aclobe E] Hardpan <br /> Previous Application Made: Yes El No New Construction: Yes E] N <br /> P1, OA <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> – <br /> Septic Tank: Distance from nearest weU--- ------Distance from fomn6ation– ---- --------Material '-------'–_-- -�_�` <br /> [] No. of compartments--------------------------Size--------------------------------Liquid 6ep+ ------------------------.- <br /> Disposal Field: <br /> from nearest woU-----'Dbf noo from �mn6uf�o------Didnnce to nearest lot |�e,--'-- <br /> – E] Number 01 lines- Length of each line' Width of trench <br /> r f,lf <br /> y pe <br /> D' ance to ne <br /> ~~ um <br /> Un | S Diameter <br /> esspool: Distance from nearest well....r15_�Distance from foundation.------J-4iii,4571ining maferiad�l --- <br /> �~ R mocle]liin a�n or �Wr�eairin (describe): <br /> I I re6y�.cer�'j y that I have F/epared this application and that the work will be(done in a rdance with San Joaquin County <br /> (Plot plan, showing size of lot, location of system in relafIk6n to wells, buildings, efc., can be placed on reverse side). <br /> _ <br /> FOR DEPARTMENT USE ONLY <br /> – KEv|EvvEu u/---.-----------' –� ��� �--_–' um� <br /> BUILDING PERMIT ISSUED <br /> / <br /> �– <br /> '--r�'����'–���''���� ` <br /> �� <br /> — <br /> v – ''-- <br /> — <br /> - — <br /> ^ �� <br /> FINAL INSPECTION 8Y�_–.. / Date- / � �@ ��'�--�-'�'_.---'--- <br /> 2= <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> /m South Am",/""" Street mo we"+ Oak S�,""+ ox svc"m",° s*""t m* w",+h ^c^ x+,m+ <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br />