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\ <br />»v APPLICATION FOR SANITATION PERMIT permit N'x +� <br />/ <br />(Complete in Duplicate) <br />Date ... V� <br />T�plication is hereby made to the San Joaquin Local Health District for a permit 16 construct and install the work herein desrribed. <br />application is made in compliance with County Ordinance No. 549. <br />CIO <br />Installation will serye: Residence [R�Aparfmenf House E]. Commercial [] Trailer Court E] Motel 0 Other D <br />Water Supply: Public -system [] -'Commurfity system El Private Er`_De�th to Water Table 61.�Q ft. <br />Character of sail to a depth of 3 iseh Sand 0 Grav'el E] Sandy Loam L] Clay Loam E] Clay [] Adobe [B-' Hardpan [I <br />Previous Application Made; Yes E] No [3 -'-New Construction: Yes [-] No gj,�_FHA/VA- Yes El No [D <br />~' ^ <br />!No septic funk or'cesspool permitted if public sewer isavailable within 200 fee+.) <br />Dis:,nce,fmm nearest well, _'�' -Distance from foundation .................... Material -_............................. ........... <br />No. of compartments_ Size . Liquid depjh .. Capacity <br />Xspolal F |d: Distance from Distance 6n fomn6 _/:QDistance to nearest lot |i Zt�f <br />Number of lines ._ �Leng th of each line -_���� Width of <br />' Type of filter mufo,ioL-���j '��n��Dep+h of filter mnte,iaL_-`����'.'.-Jot,| |ongH`--'������-_-_..--._- <br />/ . <br />SDi��nc� nearest lot <br />Number of~i�--��_---�ning ma+o,ioL .Sbo: Diametec.J-3 ----------- Depth ...... .............. <br />Cesspool: Distance from nearest we|L___-Didanc� from foundation .................... Lining material -__........ ........ <br />E] Size: Dinmeter--._------'-__'Depth _----.-__.__---._-_�q�J <�wpa6fy.................... ...,-gats. <br />' ' <br />Privy: 0��nce!fmm nouev Distance from nearest ...................................... <br />[] Distance to^6a"~stlot line ------------------------------------- `............................... ----------- ---------------- __-----_............... _' <br />R*modeiing and/or repairing +''--- --_-_'__'___-...______'-___�-_--._________'___'-_ <br />........... ... .......... -----' <br />. � <br />-'___-...--_-- .................................. -__'_--............. <br />---'-----' andf6 � -'----'--------' <br />I hereby tih that I have prepared this a0plication <br />ce with San Joaquin County <br />Ordinance$. fate, la s, and rules and regulations Of the San Joaquin Local Health District. <br />(Plot plan. showing size of lot, lo�aati n 16f,systern in.relation to Wells, buildings, etc., can be placed on reverse side). <br />FOR DEPARTMENT USE ONLY <br />BUILDINGPERMIT ISSUED --- -­............................. -....................... ............................ DATE ------------------------------------------------- _-_... <br />Alterations and/or recommendations: ........ ................................................. _--__.--_'--_-_-----_............. _................. ............ - <br />....................................... <br />L p6mo, ;/y --------------------------------------- <br />' , SAN JOAQUINLOCAL HEALTH DISTRICT <br />/oo s""m Am°ric4" Street amWest oA Street /oz uv^"°m,°a*°et n/+ worth ^C` $*w» <br />Stockton, California Lou/.c,2nf,,"/a Manteca, California n*"»C"|lf"m�+ <br />sS-9-2w. n",a"d 1'57FY.on. <br />