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APPLICATION FOR SANITATION PERMIT Ronnit No. ........ ( <br /> v / . <br /> (Complete in =°p"c~'~/ Dofa |soxe6 ..Applica-lion is hereby made to the Son Joaquin Local Health District for a permit to construct and install the work herein ' <br /> described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> Installation will serve: Residence Apartment House El Commercial [I Trailer Court El Motel 0 Other El <br /> Number of living units: Z--- Number of bedrooms 9_ Number of bafhs/t--- Lot size ---- <br /> Wafer Supply: Public system g? -Community system�.[] Private E] Depth to- Water Tableol- ft. <br /> Character of soil to a depth of 3 feet: Sand [] Gravel E] Sandy Loarn E] Clay Lo�r� [I Clay E] Adobe[n--Mardpan [3 <br /> Previous Application Made: Yes [] No A' Now Construction- Yes El <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within.200 feet.) <br /> Distance from nearest wellAZIAn Distance from foundafion---./V---------- <br /> nearest lot line---- <br /> Disposal Field: Distance from nearest well-/�,�. -----Distance from foundatio . .........Distance to <br /> Seepage Pit: Distance to nearest well- -A,�0A%_-Disfance from foundation----1A......_Distance to nearest lot line...9 --------- - <br /> Cesspool: Distance from nearest well-----------------Distance from foun6ution------ -----------Lining material ------ ---------__ <br /> Sizo. Xometec.---.--------Depth.'.�. . � Liquid Capacity- -go|s, <br /> Privy Di� 6e from nearest well � Distance from nearest building <br /> 0 <br /> � <br /> Distanceto nearest lot line----------------------------- ---------------- --------------------------------------------------------------------------------- -'-' ^«J <br /> p� <br /> ��mz�e '-'---'--'--' <br /> -.-.-.--_---_ __-____ `.--..'=��.- _-_.__-,_---.------.__-_.- <br /> .________ _ w��u-_-_ ��w�-- .-__--._--_.._-'-__-_._�--. <br /> '-------'-_---''' ---------------------------------------------------------_-'---'-_.'-''-''-_.-----'---'--_.'''--'-''_---'-'-` <br /> 1 that | have prepared this application and that the workwill6m done in accordance with San Joaquin County <br /> mn]|na'-' State laws, and rules and regulations of the San Joaquin Local Health District. ' <br /> vA104 <br /> (Plot plan, showing size of lot. ation of system in relation to wells, buildings, etc., can be place8 on rever side). <br /> FOR DEPARTMENT USE ONLY <br /> --- <br /> DATE ( <br /> wv.LD.'``" PERMIT^ ISSUED---- ------------------------- ------- ---- --------- ------------------------------- ~r � <br /> Awerm+iono and/orrecommendations: ----------------------- <br /> K <br /> _____. | <br /> —``-```-``---````--````--`--'``---`-----'----' <br /> ---- --------- <br /> .-_-. -���- -.�� ���. ---_--_----'-_---��_----__----._._-_.. � <br /> '--._-'���.'-'--'-'''---'''-''---'�"�-`'---'-'''-''_-'--''-'-'''-'''-''''-'---'-'-'''-'' . <br /> .-'-''-'''-''-'--_''''--''_-�----��'-''--''-'''-''''--''-''''-''''-''-''---''-'-'_-'_----' . <br /> � <br /> ------------ <br /> FINAL INSPECTION 8Y:_ -''----'-''-' Dofn-�� �� -------------------------- -- _-------------- -------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> '-SANJOAQU|NLOCAlHEAL[HCUSTRICT . <br /> ouS*ufh American Street 300 West Oak Street 132,Sycarnore Street 814 North "C" Street | <br /> Stockton. California L»cl/. o°|a",oia Manteca, California Tracy, California <br /> ' � � / <br /> 14S446 ATWOUD <br />