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� <br /> ----------- (Complete in Duplicate) Date issued Al <br /> ` <br /> 99 <br /> -- -eby- Date Issued ` <br /> ' <br /> Ordinance 549. <br /> , <br /> � made to the San Joaquin Local Healfh District for a permit to construct and install the work herein Jescribed. <br /> This -,, io � ith SS <br /> Owner's Name-------------------------26-4--------- ----------- 4 <br /> Installation will serve: Residence [] Apartment House 0 Commercial 0/Trailer Court 0 Motel [3 Other E) <br /> Number of living units: Number of bedrooms Number of baths J- Lot size - ----------------------------- <br /> Water Supply: Public system El Community system El P-rivate &<Depth to Wafer Table ft. <br /> 101-1 <br /> Character of onx to a depth of ° .~~.' ~~_ `] Gravel ^~ . . <br /> 9r*'iovo Application Made. (if yes,date -----------------) No F1 utruc+ioin: Yes [] No [] FHA/VA. Yes No [I <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank � pubKo ��we, � mva�a�a *�6� 200 feet.) <br /> ' ' ' <br /> - S ;+ {3istonce-from -nearest we\l^*= �.. --Distance'frvn ,foundation-------- ------- .Material--- <br /> No. of compartments----------------------- Size- Liquid 6ep+h = '''--Cupoc-lt~y.-�_�-.._', <br /> ~-,~_°.-~ <br /> Disposal Field: Distance from nearest well. ance from foundation- <br /> Number of lines------497T�- - Length of each line--- <br /> _4 Width of french <br /> Type of filter material-----��,;-�07ek--Dep6 of filter material---- -Total length <br /> Seepage Pit: Distance to nearest well---------------------Distance from founclation�-------------------Distance to nearest lot line----------------- <br />� wellUa� from foundation Lining. . material_ ''-' - <br /> Cesspool: Distance f:om nearest <br /> . ------ <br /> ---------- <br /> Remodeling . repairing ( <br /> / _-.-'-- �� <br /> " -'---_-''-''- �� ------------------------------- <br /> .4s <br /> �-___-__---�__.-'''''--''-_-----'---'''-,------'-- . <br /> her <br /> certi <br /> fy <br /> th <br /> ------'------'-----'-----'-'---'�--'-��---''` � that +�ow�r will be done in accordance with San Joaquin County <br /> | � �� m ���onan ^ <br /> [ ordinances,_ <br /> SAafe laws, anId. rules andt- .1 fi�onsof the San Joaquin Local Health District. <br /> � ''---��-'''''''-_'-�''''''_''_--�'-' an6/mr Cqnt�ctw, / <br /> p/gnou/_.��.z�.�.`�x.'^.---"^-'-�--��--_�---'�� ------------- <br /> By: <br /> _____ / <br /> � ~ ___-'-c�cc�,`--'''--�--f" �='—''''-'''----� ' <br /> ''---'--''''--''----'--- �� n��� ��eL_ ~___�~__ <br /> -'------- irelation ��, 6uO6�Qo w+*° �an �n r�vmra* <br /> P\w+ �|mn sho�lng �o��of |*t. l�ma�mnof�ysmm' « ~ ' ~~ r~.�, ____ <br /> �~ __� <br /> � /\PPL|<�*J|(�N ACCEPTED o, -(_v�=�~=�`'^'~~~'~~^~---------- - / ^ <br /> ` --���� �- - ~- <br /> DATE-------_____________ <br /> REV|EWBD BY - ---------_-------'----_--_'---. <br /> DATE .. ______.__________ <br /> ' --------------------- <br /> Alterations and/or ,ecom,nen6a�on�--------------------__-._-__-____.__ ___________________. <br /> .--.------_------------------._--.-_-__ ..---_'_ �-----.-__-----_-_'-'__-.-- <br /> -'--'--''-''''''--'--'''''-'''--'''-- ' '-----'�''''-'''-_-''_'''-''''''''-''----'-'--.- <br /> , --._---_--_--_-.__--.-'_--'������ <br /> �`�`��`````�������```�--- <br /> �__��____�__��_���-- <br /> � <br /> Do+«' -�r�'��r�'- �-''--''---'-''-' <br /> �N/\L iNSPECT|[)N BY:—----------- '' �---'---'- --' ' <br /> SANJOAQU|NLOCAL HEA�1HO�T�CT ' <br /> 1o0a,.�mm°,/*,"emm uvpvw=,Oak a=� �o*Sycamore Street onowest 9th Street <br /> m""�� c�n��� r""", California ' <br /> Stockton,California Lodi,California ' ' <br /> � =."REVISED°."""~"�"~°."� <br />