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APPLI ^ N FOR SANITATION PERMIT Permit No, <br /> ` <br /> , � <br /> \ �C��p�|� l� Duplicate) � <br /> _ ^ '� -' Du|o Issued - -���~��-. <br /> . ^ ' <br /> Applica-lion is hereby <br /> made tothe Son Joaquin Local Health District6x a permit to construct andinstall the work herein describedThis application is made in compliance with County.Ordinance No. 549. <br /> Installation will serve: Residence gA-4parfmlent House 0,,,-Commercial 0 Trailer Court E] Motel 0 Other E] <br /> Water Supply: Publiyystem E] Community system t_] Private UeOlDepth to Water Table ff <br /> Character of soil to a depth of 3 feet: Sand E] Gravel E] Sandy Loam Lj Clay Loam E] Clay U��Adobe E] Hardpan El <br /> ' us Application Made: Yes E] No P � New Construction: Yes El No <br /> CTrYPE .. INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank,or cesspool permitted if public sewer is available within 200 feet.) <br /> Septi"T' k:- Distance from nearesf v�elio-#17nDistan f fq'ugd I Verial-r-6 <br /> Disposal Field: Distance from n �arej wel�-.M----------Distance from founcla !V-Disfance to neajr�jjj I' <br /> Size: Diameter--- <br /> I'hereby cerf ify f hat I have prepared f his"application and +hat the work will be done in accordance wit[L San Joaquin County <br /> ordinances, State laws, and rules and regulations of Ae San Joaquin Local Health District. <br /> (Plot plan, showing size of lot, location of syst;m in I r6lafion to wells,'buildin§;, etc., can be placed on reve�se side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED Blr==---' DATE------- <br /> ------------- <br />' alteravnmoand/n, n,uonnmpnpat/onu:--.-_-------.--------.�_---'`--_. -/--_-------_.---_.__-__-________. � <br /> � � ~ <br /> -'-'''--------_'''''--'-''--_..-''-''''----'''--_-'---_.---'''--_.''--'----_--------_-__--__- <br /> -''''--'-_---'''-'''''--''`�--_-��--_-`'-���-' �� _-+-'--'---_--''------''-_.'__.'--- <br /> --'-_'-_-''--_-'-'''''----''---_ '- ^�_. ~�- <br /> `r'-''' <br /> -''-------'''--'' �^ -'- <br /> RN/\L 'INSPECTION ------ ------------ �!'��--��',� --''-'_-'-_- <br /> 0111/ <br /> SAN JOAQUIN LOCACHEAL--(H DISTRICT <br /> /ao South American Street � 300 West Oak Street /mx Sycamore Street ow North ~r' Street <br /> Stockton, California Lodi, California Manteca, California n`*» California <br /> � / sS-9-2m . Revised vv-2/oo ' <br />