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FOR CE USE: <br /> ` <br /> APPLICATION------------------------------------------------------ <br /> FOR SANITATION PERMIT Permit No. - <br /> ` ^������ � 0um�w�� <br /> (Complete Duplicate) Du�� |smumd �� <br /> ----.. � <br /> Application is he I reby made to the San Joaquin Local Heal+h District for a permit to construct and insfall the work herein described. <br /> This application is made in compliance with County Ordinance No. S49, e <br /> . ------ <br /> ----------- <br /> Owner's <br /> ---- -__-' <br /> Ownor's Name-.--_---- .-_---' - ---------------.-.- Phone .- .'��~ <br /> , - <br /> r�c�----'--------'---''- <br /> � <br /> Installation will serve: Residence /�pur*��n+ �wum, [] Commercial [] Trailer <�nu'+ [] Motel [] Other []^ <br /> |' �~ - -- ' <br /> Number ofliving units: -------- Number of bedrooms �- Number of 6ufh -��- Lo+ v�m -. ------........................Water Supply: Public syohyn [] Community oyxhym [] PrivmtoX Depth TO Water Table .`X.. ft � ( <br /> Character of soil to a de'- of 3 feet: Sand [] Gravel [] Sandy Loam Clay Loam �-' � �m �'� <br /> pao0 <br /> Previous Applicmfion Made: (If yes,date-------------------- Nno New Construction: Yo, E] NoFHA/VA. Yes No [] <br /> TYPE Of INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer isavailable wM|n 2DOfme+.) | v^ <br /> Septic Tank- Distance from <br /> noore0.*eA--A .^'Diotonpo from foundation----Z4� ~ Mu+uriaL.. ----------- <br /> --- <br /> --- <br /> .^ �No. ofcompu,hnnnt,--.-- y---. �- --� .. ----Capacity-'� � <br /> '� a �.^Disposal Field. Distance from nearest °mU- Distance foundation � -'D|�unce tonmum�t �tline - ~-'' <br /> Number of lines-_ ��. Lono+ of each Width nftrench'--?��---_-----_. � <br /> � Tvoa of filter mate <br /> �a|-���.����.Dao+ of filter muto�oL-���,.���-.Tof | length- ^ -�---- ~� <br /> � <br /> Seepage Pit: D;stanoo to nooro, well----------------------Distance from foundation....................Distance to nearest |o+ |;na.__-.. <br /> [] Number of pits . -------------------Lining material _----------Size: Diameter .----_--Unoth ---.. __ <br /> . Cesspool: Distance from nearest well '-'---D�+unce from foundm+�n'-'''_--Un�g material ` '-'-- 1111- <br /> Sbe: Diameter.---_._--.,,--Dept h---------------------- ----------------------------Liquid Capacity------------------- <br /> ........gu|s.�n_~ <br /> Privy- Distance from nouro, well------------------------------------------------- from nearest building'_-'-_- `--_- ` <br /> ^ 0 Distance tonearest lot line'_-'''-'''-�--''--__--_'_--_.'_'-'-''''-_.'_--'---'-�-'--'` <br /> � <br /> Remodeling and/or repairing (describe):------ _a�ca-x�n�.-- .. ^ --'-- 75 <br /> ----------- -------------------------------- ------------------------------------------------------------------------------------------------- <br /> -�-�'-----f--.--_--__--.- <br /> ....... ` <br /> '-----------------------------'''----------'------'--'--''------------'-'-'------^'----' <br /> ' ----------------------------------------------------------------------------------------------------------' ---------------------------------------------------------------------------�r, ----------------------- <br /> | hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> ��p~ <br /> ' ^ -' ''''------''-''-�-''(Ti^ --^'^~--'-~^-�r-'-- <br /> .(�ot plan. showing e�e of k�. ��mt�n in relation tx w*U� 6u�6�g* e+*. can 6m p-m�6 *m rev�r�, side). <br /> A FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED ---------------------------------------------------- ' <br /> REV|EWED <br /> BU|LD|NG P _ ' ' .--.-------_------------. DATE- . <br /> AMerw+�vm and/or ,enommmn8ions-------------------------------------------- <br /> �^ <br /> -.--__---- <br /> . <br /> -------------- <br /> ---­------------- <br /> ------------- <br /> —`----'-``-``--`---``-``---`—'-`---`--`--``----'``--`--`----`--``-----`-`--`--`-`--``-`--' <br /> '-------------------------'------------'--------'----'---------------- <br /> -_---'''''-'-------''-''-----'-_-''-''-- -'''--'''-'''-''- ---------------------------------------. <br /> -�' <br /> -''-- <br /> HNAL INSPECTION u/ tA Du��''-''' '-''_------ -'-' <br /> � LTH Q|�T���T <br /> IN <br /> . . � <br /> 1w:South American Street 300 West Oak S?roet 1n4Sycamore Street ` 205 West 9th Street <br /> y St*wm" California Lodi,California ' Manteca,California Tracy,California . <br />) cs y vcwocu 8'59 am u'^e ATLAS <br />� % <br />