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� � <br /> _, � <br /> APPLICATION FOR SANITATION PERMIT <br /> (Complete in Duplicate) <br /> Application is hereby made to the San Joaquin Local Health District for o permit to construct and install the work herein described. <br /> This application ismade iocompliance with County Ordinance No. 549. <br /> JOB ADDRESS AND LOCATION__%�_4--------- ------------------ ------------------------ <br /> ------- <br /> Installation will wy,re: Residence Apartment House Ej Cnmmo,c|u| F] Trailer Court E] k4o+a| E] Other [] <br /> Number ofliving unifs -r6 Number of bedrooms f�� Number ofbo+h, �� Lo+ �ize-'zw'��..�-��-'] �5��'^---_--_' , <br /> . - - ^ <br /> Wafer Supply: Public system [] CommunMy system ElPhvmto�� <br /> Character of soil to e depth of 3 feet: Sand [l G,ove| F] Sandy Loam E] Clay Loam F1 Clay [] Adobe Hardpan <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No vopf(cfmnk or cesspool permitted if public sewer isavailable *ifhin 200 feet.) <br /> Septic Tank: Distance from nearest ^ Distanco f foundation--'A?.---_��uhyduL_ --_. ' <br /> 1K No. of compartments-----------�~-_ - <br /> mpnf, - Cnpoci+y- '/ <br /> ' � �.^ <br /> �io, � ,'�(-���uaquudepth ' � <br /> :..'�'_- <br /> Cesspool: Distance from nearest wvU-__'_..D�+uno: f"zm fnun�u�on--------------------Lining muha,iuL-�'--__---_--- <br /> [] Size: Diameter <br /> rnvy: Distance from nearest well-------------------------------------------------Distance from nearest building------------------------------------------ <br /> F1 Db+*nu, to nearest lot line------------------------------------------------ <br /> Seepage <br /> __--__--__-___..__Snopogo Rt-. Distance to nearest well-----/-/ --'--Distance from foun6u6on_ »-Dist,ncofu nearest lot line 'T ^--- <br /> 19 Number of pits---------/----------Lining mo+o,iuL4_4�./Zu��3}ze: Diameter..197 ...........Depth-----/�.O--^.--.----- <br /> D | Field- Distance from nearest well � -:Disfance'from^fw6ndation-------9' Distance�fo � «".. * <br /> Number of | Length of each line---------05A--------------Width oftrench-..--26/------------------- <br /> Type <br /> _-_-_Tvue of filter Depth offilter material ./.2---.._ <br /> RemoJel'ng mn6/n, repairing (describe)--------------------------------------------------------------------------------------------------------------------------------- ---------------------- <br /> -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------__--___-' <br /> ---'----'------------''------'—'-------'-'-------------'-'---'-------''--'—''---- <br /> _--'--___-__-'-'-''-'__-'-__-'''___.--'___'--�-'___'-_.-''___--_-''-_-____--___'--___--. <br /> hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> Joaquinordinances, State laws, a9Arules and regulations of the San Local Health District.- _ <br /> A(Signed) pt -���----'-------------'' Cnn�a6o� <br /> ' - _---..__--_-_---_- -`-_-_--- -_------____--------- <br /> (Plot plans, showing size of lot, location of system in relation to wells, lbuildings, etc., must be filed with this a <br /> RJR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY----- <br /> --------------------------------------'---------------------------'------------------'---'-----' <br /> '-----------'''-----'--------'---------------------------------------------------------' <br /> '___._._-----._-__..__.---------___.__--_--_.____.___--.- -- <br /> 1r6 <br /> PER��|T No-__--�l.�.. |SSUED-_-.|}l-!../_.---(Dofo} HN/\L |NSPECT|{�N BY�'- _-_-_ <br /> Dote-------------------I 1 ----------------------------------- <br /> SAN.JOAQUIN <br /> .''__''-'-_.--.SAN.JOAQU|N LOCAL HEALTH DISTRICT � <br /> 130 South American Street <br /> Stockton, Ca|�omYm <br /> ES-9-2M 9-50 w^/asv <br /> /, <br />