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/ <br /> / <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br /> �� �uokca+a ' <br /> (Complete—` — -'---' Dute Issued --- <br /> Application is hereby made to the San Joaquin Local Health B|strictfor u ��rmit to construct and install thwork herein described. (� <br /> Th|su9o|icufi#ri is made incompliance with County Ordinance No. �. ! <br /> � 549. <br /> JOB ADDRESS AND 1&_V& <br /> LTATIO�N4� __ ----- --- --7..Myc�f�-------------:77�---- -- ...... <br /> Installation will serve: Residence A rtment House I-] C-p-mmercial E] Tr�ilerj Cyourt Motel [-] Ofher'C] <br /> Number of living units: Number of bedrooms e afh$A-, d 51 - <br /> Water Supply: Public system Ej Community system E] Private Depth to Wafer Me _-7- ft. <br /> Character of soil to a depth of 3 feet: Sand [] Gravel Sandy oarn E] Clay Loam El Clay [I A olbe Hardpan El <br /> Previous Application Made: Yes E] No New Construction,: A/VA� Yes E] Nc�� <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No sepfic tank or'cesspool permitted if public sewer is available wifhili 200 feet.) <br /> m r <br /> 4ios a I Field: Distance from nearest well../_-_2-,_§....Distance from foundation------- Distance to nearest lot line__4��---- <br /> ------------ <br /> Type of filter materials --;r 4 <br /> P4 Pepage Pit: Distance to nearest well----------------------Distance from foundation----_--------------Distance fo-nearest lot I <br /> [] <br /> Size: Diameter Depth Liquid Capacitygals. <br /> Remodeling and be).-- <br /> il <br /> I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, S e awLsnd <br /> d_,ogulations of the San Joaquin Local Health District. <br /> p/gnoo�.- -� .---_---------.------------.-_----(Owner and/or Contractor) <br /> �%a <br /> By:�----_--___------__.------._-.-._1`-_----__-- ' ----------------------- - ' <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). ' <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED 8Y----------`-----------.-------------. DATE----.--_-.-.- --.-_-_-__. <br /> REVIEWED KY. ' D/��. ��� � <br /> BU|LD|N<� PERMIT |SSU�D__.__---._-. D�TE_���-.�.--.---.—�-.___-- <br /> Alterations and/or recommendations:--------------------- `�-�------_-------.----__.----_--_------_----- <br /> '--'--'-----'-- ' '- -- ''--''--'--------''---'—'—'- <br /> --'--'-'-'---''----'''- '------''''--'----''--' <br /> __---_--.__--�--_. - ._-_.__-----._—_'-__._. <br /> ________________________ _ _ ___ _____________________________ <br /> .�~_ �-� �°+' <br /> FINAL INSPECTION BY�-'--'''-''��.''-����' r-~ Dut�--'''--'-'--'''_'''-''-''--'-'-- <br /> �~ ' <br /> SAN J{]AQU|I f[FIALTH DISTRICT <br /> /yu c~"m American s*°.w 30D West Oak Street /32 Sycamore Sfreef u/+ North "C" Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br />