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' <br /> ' A�LICAT�NRO� SAN���N PERMIT � � . ' <br /> � N� ���--------- <br /> (Complete in Duplicate) Do+o Issued10(_0410 -124r- <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein descriFed. <br /> ^ , <br /> This-application is made in compliarice with County 0 ' n N/- 549. <br /> .................... 604 <br /> n Jr <br /> � ----- ' -me---'------'�-7------------''---'----------------'--'--' --hone--------------- <br /> � Installation will serve: Residence 0 Apartment House [3 Commercial [3 Trailer Court 0 Motel <br /> � <br /> Number of living units- Number of bedrooms---/.' Number of baths '/... Lot size _. <br /> Water Supply: Public system [] Community system [] Privm*e;W Depth +oWafer Table --- ft <br /> Character of soil to a depth of feet: Sand [] Gravel [j Sandy Loam[] {lay Loam E] Clay E] AclobeA Hardpan � -~ <br /> Previous Application M*6m; Yws^ No O New Construction: YoyjK No E] ' <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> | (`° s°p"c """° or cesspool pe'"~'`"°d if public sewer '"available within 2°° `"=`.) <br /> ! <br /> Septic Tank: Distance from nearest <br /> ' � <br /> No. of compartments.-------- 6 depth . C �� <br /> Di ,o| Field: Distance from <br /> ^ rec+ woU' 6��� �_Distance from �mnuti ..--D 'nco to nam . f � line- ... ` <br /> Number o( lines-----------I Length nfeach |! oftrench...... -...-----_----'��`� <br /> Typn offilter mate ria| tt1`C_.9epfh offilter maforial-.1-P...............Total length.-'-_��..0--_-�-_~ ^ <br /> � Soapuge Pit Distance to nau,00 ~a|L from foundation Distance to nearest lot | <br /> [] Number of pifs............. L S 6 <br /> Cesspool: Distance from nearest well.............---Distance from foundation--------------------Lining material. <br /> [] Size: Diarrietec.-----------------------------------Oo ^ -_--__--------Liqvi6 } <br /> ' Qls+a�c6fi�on'�eareu welL._'_--'-_-.'-'^--'-'Distnn#6-fnom nearest 6vU6inig_..................................... <br /> -~ <br /> [] Distanco to nearest lot lin*-----------------------------------------------------.__.-_-_-----_''---.___''__-^--�� <br /> [ y <br /> � <br /> � ^~'^~^~^., and/or, repairing^ ^ r~^c/~, <br /> ' '` <br /> , --__-._._-__'_--.__.--.'-�_--_-__-_--_-___---__-___-''___---__'._---......... ..__- <br /> --'--------'-----------------------'-'--'----''-------------'-- -- <br /> and that the woA will be done in accordance with San Joaquin County <br /> ordinances awL and rulej/an�d rag tions of the San Joaquin Local Health District. <br /> (Plot plan, showing size Of lot. location of system in relation to wells, buildings, etc., can be placed on reverse tide). <br /> FOR DEPARTMENT USE ONLY <br /> 64 <br /> � -- <br /> BU|LD|NGPERM|T |SSUED--.-----_---_-_._'_---___-----___-------. DATE_.......................................................... <br /> Alteruflon and/or recommendations:.........................--'---__.................................... ----------------------..................................................... <br /> ........................................................................................... - .....................................---------- ----- .................- .............................. <br /> ............................................................................................................................................................................................­__­---­---------`------`--- <br /> � <br /> _-_--_--___-_---_._'...------'---'--....-'__--'--_-''-_-'''--_.----'____.__.-._-_--'__-- � <br /> .......................................................................................................................................................................................................................... <br /> ` FINAL INSPECTION BY'_- w, .�-----_--. ��+o'-�..''���^ ' <br /> SAN JOAQU\NLOCAL HEALTH DISTRICT <br /> /30 South American Street 300 West Oak Street mu Sycamore Street ww North "e," Street <br /> � <br /> Stockton, California Lms, California Manteca, California Tracy, California <br /> ss-9-2w n-5/ n=is°a vv'2/00 <br />