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' <br /> wv_ <br /> ' � ������� �� ������� ���� ��� �. <br /> ��mmp�tm �m ' Dufo Issued —"0 ~ ' <br />\\/ App|icu+ion is hereby mu6m to the San Joaquin Local Health Disfrictfor u permit toconstruct and install the work here- described.�o, ndescribed.. \ <br /> This application is made in compliance withwithCountyCountyOrcl; N �� <br /> JOB ADDRESS AND � <br />- � <br /> ^ ' —� ��-------'--'----------------'------' Phone--4~'—''~-~~~'�^' ~ 1 <br /> / . <br /> Installation will serve, Residence nrfment Ho=e El Commercial Trailer Court <br /> -- � <br /> Number of ||,|ng units: __^».. Number nfbedrooms �~' Number of 6o+h, J.. Lot size _-----.---.-- ' <br /> Water Supply; Public system E] Community system El Private � \��r ������ / <br /> -- <br /> Character of soil to a depth of feet3on6 E] Gravel 0 Sandy LoaE] Clrdoan [] <br /> Previous Application Made- Yes.E] No E] Now Construction: Yes E] No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Distance from na* s't well-----------------Distance from foundation--------------------Material --.—'�----.__—_—_ <br /> N". of compartments----- ----Size--------------------------------Liquid clepfh---------- —'---------Capacity'--'—''''- <br /> Distonrrfrom nearest woU------------ --D�sfaro, from foundation--- ----------------Distance, to nearest lot line-.—__.. <br /> Num6er of |inus_''J Length of each line- Width of trench <br /> Su i+: Distance to neunas-f <br /> � well —. � � � ./� '.. Distanceio nearest lot ------ <br /> Number of p � Lining m°+° | � S � Diom�+u - � ^vM ._Dop+k. '___ <br /> Cesqpoo|: Distance <br /> D�+ nco 6nm neu�a� °o|L'''--'�'Di���cr6om fpun�o+ina'--'''—Uningm�+°,�L''—'—'_--'____ <br /> ElSize: Diameter-.---_.����^�����--Dvptk-----'_—_--------�oui6 Capac��'_—_—'-_—gu�. . <br /> , . - , <br /> Privy: -. O;s+ ncefnom nearest well _'_ ---------------------------------Distance from nearest 6uilding'—''—_''_____—'—_ <br /> El Distance to nourv'sf lot line--------- --------- --------- --------------- <br /> and/or repairing (describe):--------- <br /> ._—_._—.—_.—__--_---_--_—._—__-----'_.__-'_.__—.__—_—__---_—._----.----_—. <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> - ---------'----------''-------------------------------'----'--'—'------'---'--- �K <br /> . "°=b ./ <br /> ordinances,. . State laws, and rules and . of .~ ~~. ~.~q.". ^"^" Health District. <br /> DAY&NIGHT <br /> "����° ' <br /> ffi-5715­5-27—or Contractor) <br /> . ~~—~.~ ' ` <br /> (Plot plan, showing size of ~' ~~~'~~' <br /> . ^ <br /> � ��� DEPARTMENT USE ONLY <br /> � <br /> - � <br /> ��r -- --------------- ---'! <br /> —.--.---'�=`�.~ ,=,'~°—.�..°�, ���w° -��---_--.--.--_—._—___--_—_--__--_-- ` <br /> --'—'—'--'—''''—'''''_'''—'''—'_''[�������—�'''__-'--'''—'''--'''—''—'-''—''—_'—'—'—'-'---'— . <br /> �_�__�__���___��_����_��__�� ­�_��_-------_--- -------- -___---___---_____------_���_---__-----__---_---_--------------__---_ <br /> FIN/\L INSPECTION QY:._ ----------------------------------------- Du+e—' ..�--- �-_-_~_'=- <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> /30 s""m Arn°,i c°" m=.t mooWest oA s*°"+ mu Sy~°rm",° Street ow North ^C' Street <br /> Sto"kt"", C"i;(6-r"m Lodi, California Manteca, California'- Tracy, California . <br /> B-9-2m n"v�se6 vv-2100 <br />