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-�°.~= ". ..-^ °°^. <br /> ' --- APPLUCATlON FOR SANITATION PERMIT Permit No. <br /> �� �moMumfm <br /> �w��p�,� _-°v �m�. |�om� __�. � <br /> . � <br /> ------- ' ` <br /> '------------ ,\ permit to construct and install the work herein dtscribed. <br /> Application is hereby made to the <br /> an Joaquin Local Healfh District for a <br /> This application is made in complian�e with County Ordinance No. 549. F,&,,Le_ A/rLOZ d� ' ' <br /> ----- ------- 444-- <br /> Installation will serve: Residence Apartment House [] Commercial El Trailer Court El Motel Other E] <br /> |� <br /> Number of living vn/nx -1---- Number of "=j" <br /> ," .~'.."~^r """ . � ^.. ^~ <br /> -- ------------------------------ <br /> Water <br /> = <br /> ---'--- <br /> Va�r Supply; Public system [] Community syshe� P,|vote'@2 'Depth noVuterTable �m. ft. . <br /> dhaxu ~mrmf mxU tm-m � � �r ��,�n| <br /> ���t� � �-f� ,-� ��� ~ [] .3wn6y-Lo—a��� Clay Loam [] C|uy [] Adobe[] Hardpan �r- <br /> . ' ` -- �_�� ^ <br /> Previous A:�Uwa�on Made; (|{yms.@o�o..�-.'-���-) No �� NewCono�uc+/on: Yes [] No r8~~-pHA/VA. Yes [I No C1 <br /> - � ^ ' <br /> TYPE OFINSTALLATION AND SPECIFICATIONS: ~ <br /> ' ^�A <br /> (No Septic tank orpermitted public sewer`is available within 200 feet.) ~ <br /> Distarnte from foundation---11------------Distance to nearest lot ....... <br /> Number o, om=v -0Z -'. L�'y' ' �""' ""�--~°---']Fy'--``'~^' of ''~'^'^' ~- »~' --'-'-' <br /> Deptk-of filter material <br /> / . . � 4� ` � --�-� `^ <br /> ` � Distance to nearest U 'I��K�. +o r�� | <br /> Ir <br /> [N~ Number of pifx----^�-------------Lining mu+oria|/U%�&- Size: u/omota,.-~:�1---------Dopth_mn?"3.--__- <br /> ^ <br /> �rnvy. "'^ta"^e 'rom 'n'eare^' well Distance- from nearest building' ---'-'----`- - <br /> ___________..________._.--------------------------------------------------------- ------------------------------------------ ---------------------------------''--'---'- T- <br /> a - ' --------------------------------------------------------'-------''---'--'--''' <br /> _I hereby certify that I liave p�reparecl +his� applicaii,;n and +�af ih�e work will be done I <br /> ' m�� �� � <br /> .(Plot plan, showing size-of lot, location ��+~� - \ <br /> FOR DEPARTMENT USE ON�Y <br /> / BU.L".."= ,"^.°.. ISSUED------------------------------------------------------------- '------------------------- ------------ DATE------------------------------------------------------------- <br /> Alterations <br /> -----'-_ _-' - <br /> Aherationsmnd/mr ------------------ ----------------------------_--------------------------------------------------------------------------------- _______.. ` <br /> '-----''-''-'--'-'''-''-''`-'-'-''-''--'''-'---''--'----''--'---'--'----'-'----'-''---'---'-- <br /> ._-_---.---'-------. .--_-----_._-----_-__:----____---'--'-_-_---_-_----- <br /> _'_-'-'--''----'-''---'/-'---.-''--^'--''-'`--''-_''-_''----.'---'_',-'-''---'--'-'---_'-_-- <br /> ' <br /> '''-'`'-'--'-'-''-''-----'--'-''-'-- <br /> -'----'--''------^'-''_-''----'-_''-''-----'''--'--. <br /> � <br /> ^ <br /> � ^��� <br /> FINAL INSPECTION 8Y�- ''-- Dv��.����r��- � - 1-''-'------'-'--'- <br /> � +� �SAJN JOu4QU|N LOCAL HEALTH DISTRICT : <br /> ' <br /> 1ooSouth American Street 300 West Oak Street 124 Sycamore Street 205 West pmStreet <br /> Stockton,California . Lodi,California Manteca,California Tracy,California <br /> cspREVISED a'5pcwx'azATLAS , <br />