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APPLICATION FOR SANITATION PERMIT ermit No. (Complete inDuplicate) ~ ' This Permit Expires 1 Year From Date Issued. plication is hereby made to the San Joaquin Local Health District for a permit to construc an n the worV,herein described. ^^^~,r'~^'^~' is mad~ in compliance ~^^~~~^', Ordinance^No. ^`' ' ov | �uoxuu��mxu�u�x//um � / . � [wmor' s Name _--- n� ----_.---.--.'----_-'''_ P6nna_ A66- -~~ -� -i-~--- ---~- . . Contractor's Name �' Installation will serve: Residence [A Apartment House E] Cbmmercial Ej Trailer Court E] Motel E] Other E] Water Supply: Public system E] Community system 4 Private [-] Depth to Water Table 40-- ft. Character of soil to a depth of 3 feet: Sand Gravel E] Sandy Loam E] Clay Loam [] Clay E] Aclobet] Hardp`an Previous Application Made: Yes E] No New Constructiori: Yes [A No Ej - FHA/VA:.. Yes No TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.)':, Septic Tank: Distance from nearest well --- 3 M, --------- Distance'f�om_ founclafionn__101� -------- 7.material�_04___-Ottik ------ / Di,posu| Field: Distance from nearest well------ 41r` ce-! Number of xnas-.-��_. _. ��Longm of each x n ov�o n - ' Type of filter material Dept �filter material .If�---------- Total length � �mgth- --------------------------- Seepage Pit: Distance to -*4--.. _6n foundation � nearest lot |ine.�~~�--�-_.-_- 9Number of pits '- Lining mofn,ia| __5ize: 'Diomo+er ..Doof-__~� / D��,� �� n�r�w�L_ D��,��m �m�u�n � �i� m��L ------------------------ Size: _ ' Cesspool:~ —'' - ----' -- - ---- / I hereby certify that I have prepared this application and that the work,will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. 41 By: ----------- * -- -e ^ of lot, location of syste Ve..n relation to wells, �4ildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY REV/EWEDDY--_-._--'_----_--.----_-----_--_-.____'__.DATE'_--_-'_-_._----___-' DU|LD|NG PERMIT ISSUED ------------------ ----------------------------------- ----------------------------------------------------------- __-.--------_.- AKo,afionvanJ/p,-.--------.-_.�_-_--_-.__-_----------------------------------------------------------------------------- ^ '----'---'--'-------'----'----'---`r--'—'--------'--------------------------- ---------------- --------- -------------------------- ��' -------'--------7--'-.-'------------'------------ ---''--------'-------'---'- ---------------------------------------------- ------------------- --..---------=~.--_.'__.----_---��_--'''-_--'—_---'''-''--.- � . ~ - FIN/\L INSPECTION BY: --- -- Du+ -------------------------------------- _---------- --.'---- AN JOAQU|NLOCAL H ICJ ` /am South American Street 300 West Oak Street ' pmzS'wm*re Street ow North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES -9-2m Revised 8-'ov,.pz".