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,----__-�~- , <br /> APPLICATION FOR SANITATION PERMIT <br /> Po�� Nu <br /> (ComcJotein Duplicate) Date |ouo �'----'--� <br /> Application is hereby made to the San Joaquin Local Health.Dist rict for a permit to <br /> | constructinsdescribed. <br /> This application is made in compliance "With County Ordinance No. <br /> ,_77- --------------- ------------------- -------------------------- <br /> Installation will serve: Residence X Xpartmenf House F-1 Commercial [I Trailer Court El Motel 0 Other F1 <br /> I ern [] Private E] Depth to Wafer Table <br /> Water Supply: Public system K Community sysf <br /> Character of soil to a depth of 3 feet.:1 Sand 0 Gravel 0 Sandy Loam F1 Clay Loam 0 Clay E] AclobeNL Hardpan <br /> Previous Application Made: Yes [I �o 0 New Construction: Yes E] No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: f eet.) <br /> ..- 1;o septic tank or cesspool perm"itted if public sewer is available within 200 <br /> ---------------------------------- <br /> �Al;�; <br /> 6p 0 sia fd: Distance from nearest well-----------------Distance from foundation--------------------Distance fo nearest <br /> ----------------------------------- <br /> Af <br /> See age Pit. Distance to neare <br /> uid <br /> acity <br /> LJ <br /> Size: Diameter ' ' <br /> D|�unoafrom n 'ny,t °a�-------.--_-----D�tonco from nov,,� 6ui|6ing--''''-�--_-'__— <br /> 'PrivD��nov +o nearest |o+ �me._-_--.--_-'_----.------'----''_-'''-'-'--''--'�-'_'-- <br /> ` <br /> Remodeling and/or n,poihnV (6n5zibe):---'''-''�_'-�'''-'''--''�����__.''-_-''�---'-'''-''_- __�_� <br /> .--_—__-_---'__--_-_-_-__.-._-.—__--_-_--___-_------------'-__---- <br /> -------------. ------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------- <br /> — <br /> I hereby ce ify that I tha v repare,6 s pplication and that the work will be done in accordance with San Joaquin County <br /> rulL regulafi s of the San Joaquin Local ealth District. <br /> f [taws, a rut and I <br />� �� <br /> ' s etc., can be placed on reverse side). <br /> (Pmtplan, show/ng wpe °" '"'. ~°~'~~ ~' ^,~-' - �- <br /> FOR DEPARTMENT USE ONLY <br /> onsand/or recommendations----------------------------------------- ---------- -------------------------------------------------------------------------------------- <br /> -------------------------------------------------- _ -------------------- ---------------------- ------ ----------------------------______'_ ______________'________ <br /> '------- --'''---'--_''''--''---''--'-_'''-'''''---''----''-'-''---''--� _-_''-�''--'-'--�--- <br /> .� � ''-'_'''--_''�-'''-_''--'-'--'--'-'__'--''_''-'-'--. <br /> --''-'-'-'------- ' ''- ^-'�''--'_'--- <br /> . -''---'--''''— <br /> '-''-'-'--''''--'------ <br /> Il �v,Du+o '''�'-----------------�N/\L |NSPECT|DN DY:--.��� w��=�����-.------ -- <br /> . SANJOAQU|N LOCAL HEALTH DISTRICT <br /> / �"= Street ow North "C" Street <br /> /3o South American Street »now+mOak e,o� /ux =�" <br /> wumm= �^|��miu Tracy, California <br /> ' �o*�"". ca\Vo�iu �j|. C^tao,o|° . � <br /> es-9-2w /0-52 nowm6 vv-Voo <br />