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APPLICATION FOR FOR SANPERMIT Permit No. -^& <br /> ~ in Dunkcuf� <br /> ' <br /> Date Issued <br /> Applica-lion is <br /> � - <br /> hereby made to the San Joaquin Health �� herein' - <br /> LocalThis application is made in compliance with County Ordin nce No 5 <br /> Health <br /> --------------- ------/-------------------- P <br /> hone <br /> Address <br /> ^- o~ �� '--' ------------ <br /> Contractor's Name--------------- -_..^-.-'_-.��---__--.--_-__--.--- P6o� ------ <br /> Installation <br /> ' �7 <br /> InstallationwU|serve: ResidenceXApartment House 0Commo' | E] Trailer Court E] Mofe| [:] Other [] <br /> Number ofliving units: �/�- ��. Number Number of6n6nzom� <br /> ' - � ' . x^ -------------------- <br /> Water <br /> -''-'--Water Supply: Public- system El Community system E] Private to Water Table�' ft. <br /> Character of soil tomdepth ofDfeet: Sand ff Gravel F � ' Clay Loam [3 Cloy [] Adobe El Hardpan E] <br /> Previous Application Made; Yes�� �� � N� (���n' Yes No F1� <br /> TYPE OF INSTALLATION <br /> ' �� <br /> ACJ <br /> TNS- ' <br /> (No septic lank*n cesspool permitted if|pu6licsewer is available within 200 feet.) <br /> kDistancefrom nearest ^=U_, ----------Distance from foundation--------------------MoteriuL----- ---------------------------- <br /> No. of compartments- Size Liquid <br /> j �i- <br /> D�Pal Fi D�stance from near t well D�stance from foundation-/- --------- <br /> Number of lines----------- ---Length of �ach line------- Width of trench <br /> Type of filter mate r�a 1--­ <br /> -------------------- <br /> Snopoga Pit Didmno: to noo,os well <br /> ------- <br /> --------------Distance from foundation-------------------Distance to nearest lot line----------------- <br /> 1771 <br /> --_---[71 Number ofpUs�-------------------Lining materiaL'-'--_Size: Diameter.--'--_Dopf6----'_--''___ � [ <br /> Cessoon : Distance from nearest well-'-''''-Dist no, from foundation-'-''-''-Uning motx6ul--''--'_-____'_ � ^� <br /> [] Size: Diameter.-- ----------------------------Depth----------------------------------------------- ..Liqu|d Capacity----------go|s. <br /> Privy ' Distance from <br /> neorv,+ .oK--- -'--_-' ---Di�ono, from nuonat buUJ�g'.-'_---_-__._'_'______- <br />' _ D&f non t, nearest lot |�*- __________- - . --__.___._.-._____Romodeing and/or repairing �enc,i6o\�' <br /> _.'--__-_------._'_-'--_-.__.----_-- --_.__-- -._-----------------_--._-_-' <br /> '-'----'--_.'-''-''-----''--'--'---'-'''--'-------_-_'-_'-_.'----_.--''_.-_._.-_--_----. <br /> ---------'----'-----'---'-----'-----------'------------_--_--------- <br /> I hereby certify that I have prepared fkl� application and that the work will be done in accordance with San Joaquin County <br /> ordinances. State I and e ,and regulations of the San Joaquin Local Health District. <br /> ---------------------------- <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings. etc., can be P ed everse si e� <br /> APPLICATION ACCEPTED BY.. s <br /> | <br /> ----------------------------------------------- <br /> SANJOAQU/N LOCAL HEALTH DISTRICT . <br /> ' /an South American Street 300 West Oak Street /no Sycamore Street m* North "C" Street <br />!` <br /> Na Stockton, CaliforniaCaliforniaLodi, California Man^o"°. California Tracy, �*|V"�� <br /> i <br /> ,45.°°..D=" .,-54 <br />