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� <br /> u <br /> --- - 673 �/ <br /> ' <br /> APPLICATION FOR SANITATION PERMIT Permit No _� <br /> N ^� ~ <br /> (Complete in Duplicate) � <br /> ' Do+n Issued <br /> Applica4-ion is hereby made to the San Joaquin Local Health District for a pe i I ci const f and in ta e work herein described. <br /> This application is made in cornpliarice with Coun , 0 inance No. 549 <br /> Installation will serve: Residence Apartment House 0 Commercial E] Trailer Court E] I ther <br /> Number of living units: -1----- umber of bedrooms A- Number of baths ---I--- Lot size 4 <br /> Water Supply: Public system El Community system C] Private P( Depth to Water Table ft. 0 <br /> Character of soil to a depth of 3 feet. Sand)4 Gravel Sandy Loam E] Clay Loam E] Clay-E] Adobe El Hardpan E] <br /> Previous Application Made: Yes E] No New Construction: Yes X No E] <br /> TYPE [FINSTALLATION AND SPECIFICATIONS: <br /> (No s fie tank or cesspool permitted if blic se -L.flaipa e? '"efg,$W4 <br /> � It <br /> IDsposal Flield: Distance from nearesff0_1-------D�stance from foundatio __A2__6-----Distance to nearest lot ...... <br /> ------- <br /> Seepage Pit: Distance to nearest well----------------------Distance from foundation------------......Distance tn nearest lot line------ <br /> [l Number of pits--------------------- Lining material -._ ------------5�zo: Diameter.-.-- --------Depth---------- ---------------------- <br /> Cesspool: D�uh,nce from nearest well-----------------Distance from foundation--------------------Lining material --------_-- <br /> [1 Size: Diameter---------------------------------------Depth'-'''-_'''--'' -----------------Liquid Capacity-------------- -'-_-ools. <br /> Privy- Distance from nouresf well-------------------------------------------------Distance from n=°=of building--------------------- _______- <br /> Dis+ �of | v <br /> I hereby cerfif a I hl rep d fhii� a5,Ii#fion and that the work will be done in accordance with San Joaquin County <br /> ordinances, State e nd r lat" (the San Joaquin Local Health District. <br /> (Plot plan, showing size of lot, locatio of system in re a '. to wells, buildings, efc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> ---.-'_-'-'---__''-''---''''--.-'-''''--'''--'---''-_.-''__----'''--'-_''--_---__.-.---_.__.___ <br /> -_.-._----.-_---_----_--'_---_-_--._--_-.__---.-_---.--.-----_-._..__--'-' <br /> ---------------------------------------- -------------�''-''''_''--'-'-'----'---''-'''-'''-'''--'''-'----------------------------------------------- <br /> '- <br /> '-''-'-''''''-�- --------------- -------------- ''-''---'-'--'''�-'''---'--------''---''--'- <br /> w� ~� ^�u� <br /> FINAL INSPECTION 8Y:----. ������� Du+o------�.-�-.-�. ------------ <br /> SAN JOukQU|N LOCAL HEALTH DISTRICT <br /> /sv svwm American Street aooWest Oak y+re.w 132 Sycamore s+re.w a/* North ^C^ Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> ES-9-2M n°./,"J vv'2/00 � <br />