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~ <br /> APPLICATION FOR SANITATION PERMIT Permit N* -/�=S_/~3. <br /> (Complete in Duplicate) Dofo IssuedApplication is hereby made to the San Joaquin Local Health District for a permit to construct and install the work <br /> herein cles <br /> This application is made in compliance with Courify Ordinance No. 549 1 <br /> -4,V-4------------------- <br /> 4r; d <br /> Owner's """'� 21 ' <br /> Ins ' <br /> [I Commercial E] Trai;er Court otel E] Other <br /> Number ofliving units: j- Number ofbedrooms -3. Number of baths -1-_ Lot size ------------------------- <br /> Water <br /> L <br /> '''----'-- <br /> Vater Supply: Public system 0CommuCommunitysystemM� <br /> am -PhF1Depthv Private D�� to Wafer Table /��. f� <br /> Characters�| to a depth of feet: Sand [] Gravel 0Sandy Loam El Clay Loam El Clay E] /\6o6e �� Hardpan 0 <br /> Previous Application Made: Yen [] No5( New Construction: YnX No [] FHA/VA. Yes 0 NO <br /> TYPE [}FINSTALLATION AND SPECIFICATIONS: <br /> (No septic if public sewer is available within200 feet.) <br /> Tank: Dim ` e � � ASupti Liquido� .. �' Capacity <br /> ` ~�--'-- <br /> 67 <br /> Di, al Field: Distance from ' - .. .". .~.. <br /> Number vf |in- - of each |in�li& � ~' .�fhnf +nan-h <br /> - Type of filter material���� �H` of filter mo+nr� | ._s---.Total |ong+h A~4-4 <br /> ------------------- <br /> � [X�� +o nearest l�� line <br /> Seepage Ht u/"ionce_*, nearest welln Distance .._. ._� - -__ <br /> Number of p|�'-' Lmaterial Size. DiameterDepth-. <br /> Cesspool: D�st ncv from nnunv� woU--'--'-u/�anc* from foundation.-'''---~...g material_ -'-'- <br /> - <br /> ' --------- <br /> Liquid Capacity'-_-- _._ <br /> ' <br /> �/ <br /> %�u� Diom�tec'__'---�_---�D o+m. . <br /> Privy: Disfoncefrnm noaostve|L----------------Distance from nearest building . <br /> Didvncu-fo nearest lot |��---_--__--_--'-__-'-_.--_-__--''____.____ <br /> ---------------------- <br /> Remodeling <br /> and` r repairing (6omcribe):----------------------------------------------------------------------------------------------- _.______._____ ____�__ <br /> --___'..___-- -__.'-'__._'--_-___._---'-_.--.--'__.--_'-_-.'''__.'''_-_--'-��--- _ <br /> -_-'---_.''__.''�-_---'_-.-�-___-�_.._-__.____..__-.___.__.---_-----_-'-_.--_._--�^�� <br /> ___..___-__._--'-----__--____''-_.''-_--'-''--''---' - <br /> --'-------'--'----�'--�-+G, --��ut�n and that the work ~U be done in accordance with Son Joaquin County <br /> ere S TT ��ef \ 6 pa� <br /> ru <br /> ordinances, fate la ska d rules and gulatio � of <br /> '\ 4and <br /> ��n:"/A- "-~'~~~-'' --�--- <br /> B»- ~-----'----'----'-----�- <br /> -�-'----'---- �-- '_- ."e�''�--'---''---_'-�--''--�' <br /> ��t , . showing size of �+ location of system in relation to wells, buildings, et*° can be placed on reverse side). <br /> [ <br /> - <br /> FOR DEPARTMENT USE ONLY <br /> � <br /> ` u�/�_ <br /> APPLICATION ACCEPTED BY-_---'__-----.-_-'---_-''_-----_-- _' -------- <br /> KEV|EVVBJ RY' -''--'''--�-'-- <br /> DATE ] �+' �� / ' p* / <br /> �e_ _­- - --- ---------------------I-------------------------------------------­ <br /> ~~�� «- Dufr '� ~~-'��''��---�'`�--'-'-' <br /> HN/\L INSPECTION 8Y�.---- s==��.-._-.���� ---._-_ -- , . <br /> ' ILOC� H��H ���CT <br /> ^ ' S�N ����UN <br /> 130 South American Street 300 West Oak street /xo Sycamore St=et m|* w"wa ^c' Street, <br /> Stockton, California Lodi, California Manteca, California - Tracy. California <br /> ES-9-2M . nv.is°a )'or Fpcu ` <br />