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' Q <br /> APPLICATION FOR SANITATION PERMIT ' Permit No. _� 3�-T <br /> (Complete in � <br /> Duo��mfe ^ z~�_� <br /> ' �-' w� <br /> Date |s,uo6Application <br /> is o Sun Joaquin Local Health District for a permit to construciad install the work herein described. <br /> This application is made in compliance wifh County Ordinance No. 549. <br /> JOB ADDRES. <br /> wne <br /> Address----------- <br /> Contractor's Numn__�-��-j��G�. J�-��. ------------ -------------------------------------------- Phone................................... <br /> Installation will serve; Residence Apartment House D Commercial E] Trailer Court W | E] <br /> Number of |i�ng units. j- ?. Number nf6o6roomo . -.. Number of baths ..V -' Lot size - ��---- <br /> Water Supply: Public system Community system E] Private El Depth to Water Table -------- ft. <br /> � <br /> Character of soil to a depth of 3 feet: Sand E] Gravel E] Sandy Loam Ej Cloy Loam;K' Clay E] Adobe Hardpan [� <br /> Previous Application Made: Yon E] Nog| New Construction: Ye` Dq No [] FHA/VA. Yes E] No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS— <br /> /No septic tank or'ces»poo| rmlft"6 if "sewer <br /> mvaUab|ew�6|n 200foet) <br /> Sapfic Tank- Di,tance ' <br /> _Mate <br /> No. of compartments 2_ l C <br /> Di,posa| Field: Distance ' <br /> Num6er of linLength ofenrh |i ~l«� Width oftre / <br /> Type of filter mn+�r�oL..��.�xJY�_-�Dnpf��of ��|fer mu[�rioL-��p�`---.Tofu| |nng+�-- - /x���'"-91�� <br /> ~' <br /> Seepage Pit . Distance to nearest well----------------------Di�,tun.c* from foundation---------------.Oi,tonceto nearest lot Jino-----' 9� <br /> [] Number of pits----------------------Lining material -_------------Size: Diomotuc-__-_-.Depf --------------------------- <br /> Cesspool: <br /> ----._--Cessoon : Distance from nearest well �----'-_Distance fnom foundation-'-'--'� Lining mufuraL'��''-''-'---�'- <br /> ` [] Size: Mamofoc- -------------------.. ---------Depth ---------------------------- --- -----------------Liquid Capacity----------------------------gals. <br /> Privy: Distance from -nearest well ''---�---'_'-''''-'�'--Distanu+ from nedest building_'-''-'''_-.---'' <br /> LJ Distance honearest lot kne_--- __ ____________..^___`___._.____________ <br /> Remodeling and/or nypoiring (describe):-----'---------------------- <br /> ---�-__.--__--'--'--.--'' \-�----__.__.-'''-'' ~�- <br /> * .� -'_--- <br /> __-__.'-______.-_---_-_-_-___-_-�-.--___-_-.-._'''----_'''__-'_-'_--_.'-'�-'-'- <br /> ^—'--'--''--''-''---------�'---'---'��-'---'---''--''--'-------'''--�''''-'''--'-''-'-'-'-'- <br /> fy <br /> I have <br /> this <br /> !. hereby 'hat prepared ''--'-' and that the -~^ ~'^ ~~ done "' accordance with S"" Joaquin County <br /> ordinances, State La-s, and rules and regulations -�� <br /> of �m ����� ���| Health Dh+��' = <br /> � -�� � <br /> ,~r~~+~ -''''~~�=�"'-"` ^"=-=`" -----------._-----'--_--' '^-- Contractor) <br /> By: � _.--__'----_.'-'_-.'-'-'''--'�-'-'''-_'''--'�-'-_(."=� -'''-'-----'----�------'' <br /> (Plot plan, showing size of lot, location of system in relation tnwells, 6uUdhmg» etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY. <br /> BUILDING PERMIT ISSUED U -- --'--------'-------- <br /> -'-_----'----'' ----'-------------------------------------------------------------- UATE----_-______________ <br /> Alterations and/or recommendations:----------------- ------------------------------------- <br /> ------------- <br /> - ------------------- <br />� <br /> ---- <br /> .- -_ - �^-.."~�=�f"°`-==r�r^/..,m�,-. <br /> �~ � � 1 <br /> --- <br /> FINAL |NSPu.//(3N BY�---.- ----.. Da+e-.5� ~.. .-('~-.---------- ------------------------------------ <br /> SAN JOAQUIN <br /> ---.SANJOV\QU|N LOCAL HEALTH DISTRICT- <br /> 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street <br /> Stockton,-California Lodi, California Manteca, California n*^v. California <br /> ES-9-2 M Rey-isea 1-57� <br /> ,nzo . <br /> � . . <br />