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. - . <br /> APPLICATION FOR SANITATION PERMIT(Complete in Duplicate) <br /> Application a to the San Joaquin Local Health Disfricffo, o permit to construct and install the work herein described. <br /> This application ismade in compliance with County Ordinance No. 549. <br /> ° . <br /> JOB ADDRESS AND LOCATION -44LxM.� --..,-'--- � <br /> Own m --------------------------------------- Phon�. J-�J-3-'7_3__ . <br /> Address <br /> ----'''-----'--''-'-----'-- ---'''--'------ 1 <br /> 7- <br /> Contractor's Name------------------------------ . --.`----------' .—' Phono-___---_-.—. <br /> .Installation will serve: Residence K Apartment House [] Commercial El Trailer Court E] Motel E] D+hn, 0 �+~ <br /> Number ofliving units: [6 Number of 6a6,00m, I~-Number nf baths r*K Lot size--..����-����.�~-------.---.. <br /> Water Supply: Public system X Community system F-1 Private F-1 ,- <br /> Character of soil to a depth of 3 feet: Sand El Gravel E] Sandy Loom El Clay LoamF-1 Clay Adobe Del Hurd � <br /> . - <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) ^ <br /> Septic Tank: <br /> Distance from nearest well-----------------Distance from foundation--------------------Material <br /> -. _.------ ---'-� <br /> [] No. ofcompartments--------------------------Capacity-----------------------Size--------------------------------Liquid depth <br /> - Cesqzoo -, <br /> F-1 Size: Diameter <br /> , Depth � <br /> \kl <br /> L� <br /> Privy: Distance from nearest weL''-'--'''-'''---'�-_.Dis+amce from nearest building��--''''''-__-''-- <br /> � <br /> K!' <br /> D|stanoy to nenra,f |c* line-.. <br /> SPit: D��n� � ' � � 6_-_D��� � a��� |� | % <br /> --------- <br /> Number of p '- Lining mo+e�u|e. 914S' Divmv+v,- � � oof �;� - � <br /> ------------------ <br /> Disposal Field: Distance from neo,m �'--- � fvun6uticm'--'''''-Distance to nearest lot line---'__-- ` <br /> L] Number of lines-----------------------------------Length of each line------------------------------Width of trench--------------------�-_^�- <br /> Type of filter material ''' Depth of fite" material <br /> ~~^'"d='w ="/", ,"pa.nne pv,cnoeF � --------------------------------------------------------- <br /> N <br /> _ <br /> ' ___._________.____ <br /> ----''--'-------------�'-''^�--'-'—�--------�--'---_---/ - -_______ --------------^---------------- <br /> -----------_''--____----_--_..,-----_-_--_--_---_-_-------..___------_--- :� <br /> ordinances,I hereby certify that have prepared this application and that the work will be done in accordance with San <br /> County,~� <br /> (Signed) <br /> , _ ,_'` - gs, . <br /> '- <br /> ' <br /> FOR DEPARTMENT USE ONLY <br /> REVIEWED BY ~~ <br /> BUILDING PERMIT ISSUED <br /> ----- <br /> ---------------------- <br /> ��� <br /> . ^� ___________��_ DATE^� w-"- <br /> A�erat�nomn6/nr ,ecommon6u�nnu-_-_ - ----�----- _ ___^- ---- _�� <br /> _��-�_�_-7^�---_-.'----_'__ <br /> -'_-__--'--_-''----'''�^',---''_-''-'--- -'---'''----��__'''''-__-''---''-_.---'----------------------------------- <br /> PERMIT <br /> '--'--^'''' <br /> ���--^_-.__---__--.-_-_--_--�----..__--'-'''-_-''----'''-__''-'-�'''-'_-.'--' -_.''--'-_' <br /> _-_--''_-'''- __-''-_''''-''_-'''_-'''---���'---''--'_�_''''-__'''''��-'''___''�-'''- '--'''-''- <br /> .__.__'_----.-------_-_.. ---_--_--_----__------�_.-- ._-_-- <br /> ' <br /> pERM|T No/4— . |6SUE[\. ^ ^ ���K-.(Dv+o> FINAL INSPECTION 0Y�- �L _ �________� <br /> �~~ <br /> / . <br /> Date '---'''-^� � <br /> � S/kN J{}AQU|N LOCAL HEALTH DISTRICT � ^ <br /> 130 South American Dfnent <br /> Stockton, California �^ <br />