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APPLICATION FOR SANITATION PERMIT Permit Nu ._ <br /> � Duplicate) <br /> (Complete ^� Do+o Issued ..- �����.x-. <br /> Application is hereby made to the <br /> . . . . <br /> San Joaquin Local Health District for u permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549 <br /> Installation will serve: Residence E] Apartment House L] Commercial E3, Trailer 'Court [] Motel E] Other Vf <br /> Water Supply: tublic system, Private El Depfh�,;66 Wafer Table-Irff. <br /> Character of soil fo"�a�depfh of 3 feet: Sand Lj Gravel 0 Sandy Loam',V Clay L�carn El Clay E] Adobe Lj Hardpan 0 <br /> Previous Application Made: Yel F1 No 8-_;�New Construction: Yes&-_NT07jE] F HA/VA: Yes Ej No E] <br /> JYPE OF INSTALLATION-AND-SPECIOCATIONS: <br /> (No septic tank or'cesspo'ol'permitt�d if puLlic sewer is available with;ir'200 feet.) <br /> -'Septic Tapk' Distance from nearest <br /> ------------------ <br /> �Zllpl I ield.- Distance from nearesf "ell Distance from founaafi n---A----------Distance to nearest lot line-----. ........ <br /> ---------Length oi _y <br /> See Pit: Disfance76 nearest welf_��---------------------Distance f f d t,Dn__` rest I t line <br /> be pits a------------Lining materia'A e: Diageter.----- Depthr <br /> Qom �;F- �4,j- ------- <br /> ZV� Num r of <br /> oundat <br /> Cesspool: Distance from nearest wel----- ------ ---Distance frowion.-- I------------Lining material---- 0 <br /> �Pri,y: Distance from nearest. <br /> Remodeling anm/ p� �e be) <br /> --------------------------- <br /> I hereby certify that I have- prepared this1rapplicafion and that the work will be Oone in accordance with SanfJoaquin County <br /> ordinances, Stafe,laws,,andrulers-r and rV061W�f of the Sanjoaquin Local Health District. <br /> (Plot plan, showinj--siz-e-of I6t,'I;c-itio_norsysfern -in relation to wells, buildings, etc.. can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> ------------ <br /> Alterations and/or recommendations:------- ------9Vj ---------- -­--------------------------- <br /> -------------------------- ---------------------------*-----------------**----------------------- <br /> '------- ..............................-� ----------------------------------------------------------------------- ----------------------------------------------L-..__.----___ <br /> _------'-- �^---~i.''_-'''--''-''''-__ ' U � . <br /> , ' ''--''''-'�,�''r'''-�''--'''-'�----T'----'-- - <br /> '----,^-----'-----'-`-'------------------'—_--`-- � ��. z <br /> ��-----_---- �� --.___. <br /> —'---'-''-''--_-''--'''''__.''-' ^ ~-''--'-'-----'''''-'''-'''--'--'''-''-'''---''-'-'-'-- <br /> ' <br /> ` - yRNALiNSPECT|(]N� BY�/��' � -'�-'- � Du+� ��..'����-_-.------_--_._S�N JO���U|NL[%��LH��LTH �|�T0�T . <br /> 130 South American Street 30D West o° S+rGet /sz Sycamore Street u|+ North 'C' Street <br /> Stockton, California Lodi, California Manteca, California nm"v, California <br /> sS-9-2w ' Revised 1'57F-pc0. ` � <br /> , <br />