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��ION �R �N�� RM� P�� N� 9,2, � (Complete ' ' Date Issued as ' Application is hereby made to the San Joaquin Local Health District for a permit to construct and ipsfall thq work herein described. This application is made in compliance with County Ordinance No. 549. 1X4411— S�.� JOB ADDRESS AND Lq�ATIOIN--- ----1k,�_ ---------I- ----- --- - --------------- - ------- - --- Installation will serve/ Reside °, . Apartment [] Commercial 0 Trailer Court [:] Motel L] Other [] units:/---- _�` � Number of living units:/----- Num6orof6o6om�� . Number �� 6u+�, - Lot size _-__-- Water Supply: Public system El Community system El Priva � to �n�r ��=�� ��m�� soil toa depth �� feet: Sand � GravelE] �n� LX Depth [-] Clay Loam [] Clay [] Adobe Hardpan � Previous Application Made: Yes E] No Construction: ~~°Yes �] No n� FHA/VA. ��~� ~' Yes No TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic fankm,'oompmv| permitted if public sewer is available within 200 feet.) ' ic Distance from nearest waif----------------- from foundation--------------------Material ---._----_.______/u ^ Nv. of compartments------------------------ -Sipa----------------------------Liquid 6epfh-.-------.(�op�oJty-._-----. -` r Di`+oncv from nearest wuU---------------Distance from foundation-__-- Distance to nearest |o+ line-.--_- Num6vr of lines-----------------------------------Length of each line------------------------------Width uftrench----------------------------------- �6 Type of filter mnforiaL__ -----Depth of filter moteriuL--------Tot | length ------------------------------------------ Seepage --------_-_--. Seepu Pit: D�+ nco to + � �- � ^ Num6nrofp��-' ---Lining no+;,�L -S�o: Dk,mo+uc-36------------Depth-o?,�-----_--' Cropoo|-, Distance fi-om nearest || Distance from foundation-------------- ---- Lining matedo| Privy: Distance from noarestvrL''��- ------------- ---------------------Distance from nearest building.'--''�_.'-_.'-_-� [] Distance to nunnas+ |o+ |ine,'-,_. .-----------__--__-_�.-.,______________`__________� �r� � Remodeling and/or nepoir;ng /6vscri6o\:-----------------------------------------------------------------------------_-__'__--------------------------- ----------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -__'---_''----- � ---------------------'------'--'--'—''---''--'--------'--------'---------'----''?`I --'----'-------'--^---------'-----------------'----'--'-----'---------'------ / I hereby erfi that I have prepared this application and that +he work will be done in accordance with San Joaquin County; ordinances, Sfa [a s, and 1rujis and reg, ulations of the San Joaquin Local Health District. 41 � �p�nou - _- Contractor my�_ .. �k ''''---'--'''--''' '-'---''—` / (Plot plan, showing size of lot, location ofsvah�� -in ,e|m�on +o w��' b��inqo. etc., can be placed on reverse side). -�- ~ � FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY---------- .---------------------------- DATE-- _._._. REV|EWBD ---''- DY-�---'--_—._-_--- - ------ __. �O/T~E/.� � _. BU|LD|N5PERMIT ISSUED------------------------------------ -''-'_-.'- --------------------------- DAT Alterations and/or recommendations:---------------------------------_-____._----_-_�__---__-_�_.__..________°_^�.-. _- _-_--__- � . ��_�_��_��_��___��___��'__�- �_��__�___�____��__�� _��_��___� _�_��__��'��'�_��' '----------------------------------------- '-�----'- 1-'---'--'------' _-'_-----'''-_-'_'''--'''-_'''---'-'''-'''_--'-_-''__-'' -'`'-_''--'-+''_-.-_.---_.--__--' ----------.-------__--------'--.----_----_--_------^--.--.---.-----'_-_ �NAL INSPECTION ---'-�—. Dmt '.f�.-� / _''----'''-_____ SAN JOAQU|NLOCAL HEALTH DISTRICT mo South American Street 300 West Oak Street /oo svc°m"= o,° 814 North ^C^ Street Stockton, California Lodi, California Manteca, California - na"» California ES-9-2w . Revised 1.57 FY CO.