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� <br /> APPLICATION FOR SANITATION PERMIT Permit No. ` <br /> �omm�� � Duo�a�) <br /> `--'- Duplicate) O^+v Issued <br /> � <br /> Application is hereby madefothe San Joaquin Local Health Dist 6cffor npermit toconstruct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> Owner's Name--- --- ------ V........... <br /> Installation will serve. Residence Apartment House E] Commercial [!] Trailer Court [] Mof9l 0 OfherjEl <br /> Number of living units: ----E Number of bedroom, <br /> Water Supply: Public system [I Community system C1 Private Number <br /> Depth to Water Table ft. <br /> Character of soil to a depth of feet: S d Gravel E] Sandy <br /> Clay Loam ��Clay E] /�o6eF] Hardpan [l <br /> �eNew ���� /� �Made: &m [l Np C�d�dinn: &m ~� Nn El | <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: -i <br /> ~�' | <br /> (No septic tank or cesspool permitted if public I ewer is available within 200 feet.) <br /> Septic�ank; Distance from neairest wellc- t '81- ---- ------ <br /> Disposai'Field: Distance Trom nearest we�LI,5_0_T-Distance from foundation--O I nearest lot line- <br /> Number of lines Length of each line-------- Width of french <br /> Type of filter of filter material <br /> \ <br /> Privy.' Distance from nearest well Distance from nearest building---------------------------------------- <br /> . <br /> 171 Distance to nearest lot line-._---_-----.----_-_---_.___--�--__..__'_._________ \ <br /> RemodeUngand/or napui6mg (describe):------- ------------------------------------------------------------------------------------------------------------------------------------------------- <br /> --------------------------------------------------- -_---__--__-.-__-----__-_--__�-----__-_-_-_--__-'_.__-' . <br /> _'--__-__.-'_--_.''_-.-__''__.-_'-_-.�___.'-----__--_-''--__-_'_-.-''�-''--_.'-_---''-''-_.�-' , <br /> ' <br /> --------'������------------------'----------------'���������---------------------------------------'----------'---------------_--------__------'�����----_-------__---___---_ <br /> ' preparedfhio application and that the work will be done in accordance with San Joaquin County <br /> ordinances,�S�f laws, and rules and regulations of the San Joaquin Local Health District. <br /> ------------------- <br /> / . <br /> By: (Title) <br /> be placed side). ' <br /> BUILDINGFOR DEPARTMENTUSE ONLY <br /> ------------------------------------------------- <br /> . . ^..,.. .~~.E~'--''--''--'-''--'''-''''-_--''''-__''-_.'-'__ DATE----------_''�---''--_.-,-__''- <br /> A|tnmtions and/or rpc*mmonJaHuno:--- -- - - <br /> -- - - - - - -- - - ----- - --- -- - - - -- - --- -- -- <br /> _- - -- - ----- - ----- - -- <br /> - - - - -- -- - -- - - -- ._------.__--- - - - - - - - -- - - - --- ---- - --__._---_- --- - - -- -- ---- - --- � <br /> ---'-''--^---'''------'----''''''-''----'-''- ---''----'''--''''-----''---------'''--'---'--'---- 1 <br /> '_-__--_-.-____--__.__- - - - - - - - - -- - - - - - - - - - ---- - - - - - - - --- - --- - - -- -- - - -- - - ---- � <br /> - - -- - -- -- -- -_-----'-- --- - - - - - --- - -- -- - - - <br /> ''--' - -- - -- - - <br /> --- <br /> --- - -- - - <br /> . � �� <br /> �N'�L �NSPE�TC�N BY�-----. U`�===---- D�+o -''`�-_/ -- --'�/'-'�~�-_- - - - - - <br /> . <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> /oo s""m American Street 300 West Oak sfr"° 132 Sycamore Street 814 North "C" Street <br /> Stockton, California Lod;, California Manteca, California Tracy, California <br /> ES-9-2M 8-5/ nv,mu W-2/00 y <br /> ^ <br />