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FFl <br /> T�plicafion is hereby made to the San Joaquin Local Health Dist ricf for a permit to construct and install the work herein described. <br /> is application is made in complianC6 with County Ordinan S�kv o. 549. <br /> ------------------- <br /> ^^w"=r^ ..""=. * <br /> , <br /> InvtaJla+ion will [] Commercial Trailer Court [] Motel 0 Other <br /> Water Supply; Public system [] Community system Private te =e-6epth to <br /> Water fable <br /> - ^ ' �~�= [n^ <br /> Character �� <br /> mr w� to m depth of 3 feet: Sand E] [] Sandy Loam [] Clay Lb� �] Clay [] Adobe�� wrdpan [] <br /> ~,~^�� <br /> Previous Application Made: (|f yes,date-------} No E] New Construction: Yes E] No FHA/VA. Ye* 0 No [] <br /> TYPE OFINSTALLATION AND ^ <br /> (Ne septic tank or cesspool pe�mitfed if public sewer is available within 200 feet.) <br /> ._ of ---,--_. --------------------------Size--------------------------------Liquid .~',.`------------------------Capacity....................... <br /> Sal e Distance from nearest well------------------ from foundation--------------------Distance to nearest lot |ina-.............. <br /> Number of lines.--I-------------------------------Length of each line------------------------------Width of french -_.'-_''-'-_--- <br /> Type of filter material _.__- Depth of G|h,r material -- 'Totu| length. <br /> . ' ' � <br /> Seepag 1K. D;sfanc.. ell- 1104)........DistaneT.-Nrn-foundation---7-5........Distang to nearest lot <br /> El Size: Diameter <br /> ^� . � <br /> Privy: Distance from 6�a�s+ °m|L''�_-'---''-''-''--''Di,*�oo from noone� 6mU6�g'`----.-_--_-__ <br /> [] <br /> Distance to nuuresHo+ line--------------------------------------------------- -_------------------------------------------ <br /> ` <br /> ' � . <br /> Remodeling and/or ------------------------------ <br /> '_-'____.--__._._.___- ^ --------------- '--___.__-..-L_-_--__.___._---___.____.___^__ <br /> ., " <br /> '-'---'-'---''--'-''-_-'--. '-----_-_-___.-���=__..___-----'-'-_--__-__.-_--. <br /> `V ~ - --~ <br /> . ~~~. . <br /> . <br /> / <br /> ndgulations of the San Joaquin Local Health Distric+. <br /> c���' m_������- . <br /> ---------- <br /> ! <br /> - --------------------------------- <br /> (Plot plan, showing size of lot, location of system in relation to ells, buildings, etc., can be placed on reverse side). <br /> Z�7F OR DEPAIRTMENT USE ONLY <br /> REVIEWED °'_'_-.-'-'-�~" -'-''_-'-_'''-'--'-'�r'- -� =__.__-_ vn.�.--.-_-_-____..____ � <br /> BUILDING PERMIT ISSUED ^ ` -- \ <br /> ------'--'---'-'—'—'---------------'-------------'-'—'''-r-----------'--'--' ' <br /> ^ ~ - <br /> -'-- ----'__-''_-�_'--'-''-''-'''-''--'-'--'''---'_------''----_---'_�--_-----`'- --.-_._--''-� <br /> 41 <br /> '------------' ----------------'----'�.---------------- <br /> -------------------------------- <br /> —'-- [ <br /> . � . . <br /> -'-''-_-_''- ' ' ------------------------ ----------------------'-''-'-'-_--_'-'-- <br /> ' <br /> HNAL (MSPEI�T|C)N Date-----."� <br /> SAJNJO�X�U|N LOm��� HEALTH DISTRICT <br /> ! <br /> '~ ' <br /> 130 South American Street wmWest Oak Siroet 124 Sycamore Street 205 West 9th Street <br /> ewckm" California � Lodi,California Manteca,California Tracy,California <br /> "o v ""VI"v" w',vxm 5-61 ATLAS <br /> � <br />��~- - <br />