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APPLICATON FOR SANITATION PERMIT Pn�lif No, ' (Complete in Application is hereby made to the San Joaquin LocuHea|th District for a permitfo construct andnsto the This application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND LO ATION ----- Installation will serve: Residence ��Apartment House [-] Commercial E] Trailer Court [:] Mot 1 91 El Other E] Number of ]Mng units: a7_ Number of bedrooms --- /_ Number of baths Lot size Water Supply. Public system M_--c-Immunify. system El Private E]_ Depth to Water Table -5/6 ft. Character of soil to a depth of 3 feet: Sand E] Gravel E] Sandy Loam E] Clay Loam [D Clay E] Adobe 29-`H�arclpan 0 Previous Application Made: Yes E] �o [E�' �PNew Construction: Yes E] No [5- . --F-HA/VA: Yes F] No 0 TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tankor' permitted if public sewer is available within 200 feet.) t;l Distance from nearest wuU---.--Distance from foundation -------------------- Material --'_----__--_ No. ofcompartments '''-''''------ Size -_''__'''-'---- Liquid 6ep�h -------------------------- Capacity '---'-'-'- Did : Distance from nearest well --------------- from foundation -------------------- Distance to nearest |o+ line -_--' Number of lines ------------------------------ ''Length of each line ------------------------------ Width offrench '-'-''''_-'-'-' v Type of filter material Depfh of U�~ �Seepage �|�� material Tvt | length----_-___ -_ ' ''- Nu�6�rof�t�.-cwL.'---L|ning �uie�a| --- Size: D�muiur�`3��.'-Dopt��^��~'-'''- Cesspool: D�sfanco fnom�noan,st we|L''-=~.,_Distance from foundation ---------------- --Uninq mu+e,aL---------_-_- D Size: Diameter ------------------------- :------------ Depth ------ -------------- ------------------------------ Liquid Cupocity---''-''-'-'ga|s. Privy: b|stanoo from nea�est well ---------- ------------------------ --------- !-Distancv from nearest building ----------------------------------------- } [] D�tunce+onno,�f�tline --''��-��'--','-_---_.'--_'-'---'--'__---_�-'-'-''-'-'- Remodeling an ' r ,apo�hng (de, r;be): --------- ------------------------------------------------------ --------------- _.----------------------------------------------------- -------------------------------------------------- ------------------------------------ -------- ----------------------- ---------------------------- _______________---__'___ ' `�- i�_�__----'''-'-''--'-----------------''--'-'--'--'----'--------- I herebycerfify t ie pr�p�red this application and that the work will be done in accordance with San Joaquin County _u a tons of the San Joaq (Plot plan, showing size of lot, location of system i io�� wellis, uildinigs, etc., can be placed on reverse side). el K;11� FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY --- dl_il- __-'------_-.''--''__'''__.'-'-''''-'''_-''---''-_.---_.-'�-�'''_''--_.''--.'__-----__-__._--- -.__.-._-_._----_-._ '-------------------- ------------------------------------------------- ----------------------------------------------------- --------------------------------------------------- '----'''------'''---''_------.,--'''-'---------- ------------------------------- '-''---- . . '� -------------- ---------------------------------------------------------------------------------------------- FINAL |NSPECT| K Date ��'�� , SANJOAQU|NLOCAL HEALTH DISTRICT /so South American Street am West Oak Street . /uu Sv" M"TO Street m* North "C' Street Sfock+on, California Lodi, California Manteca, Calif6rnia Tracy. California IS -9-2w n".is°a 1.57 ppzn � K� ^.�