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^ <br /> No. ~~~ - - "z <br /> APPLICATION FOR SANITATION PERMIT Perm - <br /> ' <br /> kCwmmleta in --- <br /> Duhy Issued <br /> g A <br /> plication is hereby6 +o H` 5 Joaquin-Local Health Dist r|c+for a permit tconstruct � <br /> 6 install k herein described. <br /> application is made in'compliance wi or d 77_*w <br /> Owne <br /> ---'---- Phone'(?-gd-''�'�-' <br /> Address--__.-'- _ __----'-'---------------. ------- _-.--------------------- -------------------------.. ---.._. <br /> �� <br /> ��ontructo,', Name_ --.�q�����--.=�..��---.------- P6one-���.��.��..�-=-. <br /> |n�aUa�mn will serve: Residence [] Apartment House [� Commercial [� Trv8or Court [] k4o+o| Other <br /> Number oflivi--�un�ts -------- Number bfbedrooms -------- Number of6u+h, Z' Lot size -./ �~�l'/.-��-L«_��-^---- rJ <br /> \�ato, - --�� ---'- '~ �� '- -' <br /> Sup��: Public ��m �� CvmmunHY system 1711 Private F1 Do�� � ��r ��|o �_ � <br /> Character of soil toadepth of 3 feet: Sand E] Gravel [] Sandy Loam E] Clay Loam El { lay��!, Adobe E]. Hardpan E] <br /> Previous Application Wade, Yes . No New Construction: Yes 3K No E] <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic <br /> Distance from nearest well Distance from foundation--- <br /> No. ofcompa�mon1�---��--'--Sio��� ��^�. Liquid <br /> 'e k ,............Copucif^ <br /> r ` <br /> Disposal �e|6: Distance from .eU 6n foundation ^^ <br /> 19[ NumberoJ lines ---Length of each | oftrench--4-V-- -''-'-- <br /> Type of filter ��-Dep+h of filter ma�toriuL�.~l��---------- length--���..,---------------------- <br /> - <br /> Seepage Rt: Distance to nearest �o to nearest lot line--- <br /> Number of .� .-'/------------Lining material ----5ze. Diametsr_�q2 `~.-'-Duoth-'�2.jA---'-''-�- <br /> Ce0000 : D�st noe from nearest well-----------------Distance from foundation--------------------Lining material '-''-''-'''---' <br /> Size: Diameter-------._------ ----Depth------------------------------------------ -----Liquid Capacity-'-------.go|o. <br /> Privy: Dis+ nco from n=o,nv well—�������---'__'--'—'Distance from nearest building---------------------------------- '_ <br /> Distance fo nearest lot line-_-------------- .------------------------I-------_-_.-_'_---------- <br /> ^ *� <br /> ^ <br /> UV U <br /> -�--_._-..__.—'_.---_.___-_�__--___-__'--_--__..___.---_-__------__--_--.--^-----. <br /> --'''--'''-'''----'--'''__-''--_-'_-'--____----''__.''-_.'''-__--'_-''-''---'-''-''-'-'-_''— <br /> ' I hereby certify fhuf this application and that <br /> ' <br /> (Signed).... <br /> � �p '-'y -'''--- <br /> (Plot plan, showing six of lot, location of system 'towells, buildings. efc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED <br /> REV|EVVB} 8Y. --.---.—.---_--_-_-_—._. DATE <br /> DQ|LD|NE� PERMIT |S�UED__-''3��-_.'-----''''-''-_'--_'''--'---'''-' DATE'''1K�----------------------------------------------- <br /> Alterations and/or <br /> _---.--______Altn,uGnnunnJ/or -------------------------------------------------------------------------------------------------------------------------------- <br /> ---------------------------------------`---``--```-```—```--```--`--------``--'``------`--``---`--`--'--``--'----`-- <br /> ------'-----------'---'--------------'--'-----------------'--'------'' <br /> ------__-----------____-----__--­_­-------__��-------___---__------__---_----_��������_���- --_��__����___���-----__---_---_------------_--------------- <br /> --'''-'--'''-'''-''''— '''--''' '''-''''--'-'-'''--''''—'''--''''-''-''---''-'-''-''—'- <br /> � ;4 6-1,5.�� <br /> FlNAL INSPECTION 8Y�--- �-__----. Date------ <br /> JOAQU|N LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street /32 Sycamore Street 814 North "C" Street <br /> Stockton, California � Lodi. California Manteca, California Tracy, California <br /> eS--9-2w m-52 o"vi,vd W-z|ow � <br />