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v� <br /> APPLICATION FOR SANITATION PERMIT Permit No. ^� � <br /> ' (Cwmp|efe in Dup|iom+*) Date Issued _4124-.e'- <br /> ' permit construct install described. <br /> 6 6m � to +h San Joaquin Locu� Hno|fh District for u pcun ru ^Q, <br /> ---- <br /> Application �s era-' made * o withC [)n]i N 549 �� <br /> AJO <br /> JOB ADDRESS AND LOCAT, N_ 4 <br /> Installation will serve: Residence [Z Apartment House El Commer6ial [] Trailer Court El Motel Other El <br /> Water Supply. Public'system El Community sy f Private 5?rDepth to Wafer Table _-P <br /> Chara�fer of soil to a depth of 3 feet: Sand �Xvel F1 Sandy Loam '-]'- Clay Loam El Clay 0 Adobe Hardpan E] <br /> previous Application Made: Yes Ej No V--New Construction: Yes ;/No E] F I HA/VA-. Yes [I No [I <br /> TYPE OF NSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or'cesspool permitted if public sewer is availa6le within 200 feet.) <br /> Septic Tank; D�sfance from nearest weil---rj��_ Disfance,from 3-------------------Capacity------- 1Z, <br /> No. of compartments--_.� _ya.: <br /> Z sf lot line-- <br /> Disposal Field: Di4ance from nearest well__S��--------Distance from foundation-Y to neare ---- ----- <br />� <br /> Ty. <br /> ' nearestlot l <br /> � Number of- ro Lining ^'`'~''~'-----------------------Size: Diameter I <br /> Distance from foundation---------------- --Lining" ^'~-'~' --�---- <br /> D���+e u°v"' ''�----� . ~, _�~~~ <br /> --- ���� <br /> Distance from nearest """"" g ------------------------------- <br /> Privy; <br /> _ <br /> . . .,, <br /> ~^'~^^~ to nearest-� - ' | U <br /> __.--_--''--__'�~~" <br /> Rcn�»6�|ng and/or repairing �e,cri6o\�---_--'-_-._-..___---�__-__''-_'_---- _________�___. <br /> / -_.-_.'--''-__.---_''_--''--'''__--'--'''�_.---'_-'--'''''-_-'--_-'''-- --' <br /> \ ______._______�_.____'_____,�___--_-._---_----'---------''--_''---------''------'---' 0^ <br /> - ' ----____--_--'-_-__.----___'____---'_--_--' <br /> � -'-�-'---''--'--''-----^-'-----'-----' n6 fhoff�awor �0 6o done a��ur6anuo ��h San Joaquin/ +kmf | 6 n,6 |h& m k~~�^ <br /> s of the San Joa7qu n <br /> ordin�nces, State laws, and <br /> �n�}-�� � » �^�'-------- Local Health District. <br /> �' ---=-- <br /> \» � <br /> --------------------------------------------------------------- <br /> --------- -- <br /> I -_. '---'-'--�___-----''�'"�+------'------- <br /> -'-�-� --------------------------- ate., can be placed on reverse side). <br /> (Plot plan. . ' mflot, location of relation to wells, buildinbuildings, <br /> +�> <br /> LY <br /> PX ---------------------------- D <br /> / '_--- <br /> '---,'--_ <br /> AKn,atonown6/o, n�_-_________.____-____ ____________.______._________ <br /> ' <br /> -'----�-_'----'''--'-'''-''--''---''--''--.''--__--`-- -_''-_.''-_' '-_--'-_-.''--'---_.-_'--.' <br /> --- �' '-__'-_-_- - <br /> -----�_' --.--'_---._-._-_----__------'- -.�''�''-'-'''--''-'''''--------- <br /> ^ �� <br /> `*~ Date '`Y'/ ��-'--''-.'-''__' <br /> FINAL INSPECTION �BY�----����',�^-��'—��=-----` - -'r- ' <br /> � <br /> SAN JOAQU\NLOCAL HEALTH DISTRICT <br /> 130 South American y�°m soo*/�� �^� $=° /zz Sycamore �w° ow North "C" Street <br /> ° w^"�w"= o°|*"=}* Tracy, Californiae"��". c"\�","|" Lodi, California . _ <br />