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~~� _7� v "~ APPLICATION FOR SANITATION PERM- � �� . ' � Rwn� N*. ...�'� �� A.'a- 0 � (Complete in Duplicate) Date Issued .7/ This Permit Expires 1 Year From Date Application is ha,a6v made to the San Joaquin Local Health District for u permit to construct un6JndnUthowo,k ku,o\n 6oxc,i6o6. . This application is made in compliancewith County Ordinan No. 549. 4 � DisposalInstallation will serve: Residence 23"Xparfment House E] Commercial E] Trailer Courf-E]- Motel Other E] Number of living units: -/.- Number of bedrooms ---A-Number of baths --- Lot sliz�e -------------------- Water Supply: Public system P11"E'ornmunity systern [I Private Fj Depth to Wafer Table //! f-F.- Character of soil to a depth of 3 feet: Sand [] Gravel E] Sandy Loam E] Clay Loam E] Clay E] 'Adobe 1241"'H'arclpan El Previous Application Made: Yes [] No 4?"-New Construction: Yes [] No gj---T-HA/VA,:,Ye; 0 No 91� TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if pu6lic sewer is available within.200 fee+.) Distance from neafe5f well--------—------Distance from foundation-----/P--------Distance to nearest lot line- --------- Number of lines e ac6 |ino, ~��.. VVi6+k of trench. ------ --------- Type of filter mate ria|+��Lx�474�5�Depth of filter mu+oriaL-..��.�.�-..Tof*| length.-'��'.�-------. . ` x _ » V Seepage Pit: Distance to nearest well ^ Distance to nearest | | %:� ^� Number ofpits-.��---'--Lining muforioL4J4�k'Size. Diameter-2,-q----------Depfh..A_S._� -1--- -- ' Cesspool: Distance from nearest we|L-----Oistonco from 6ound^+i�n-~------[ining material ------------ [] Size: Diameter-------------------------------------- ------------------------------i._._-._.Uqui6 .Cupo6ty --------------------------gals. w Privy: Distance from nearest well '''_-''-''-''-'''-''Distance from nearest building. �-'''--'-''-_'- [] Distance to noon,st lot line- ---_----_---___-__—.. � komode�g and/or n,poi�ng (describe):.-'''-'� -�0 --'''---'''__'_''_________ -_--_-.__---__---'__-�'_----_--_---___-_---'_-__~-_-.+_---'_-----_------ '-'-'---_-''_-----''-'_-.-_�'''__.'--_'--.'''---___-_-'''-'''__.-----''-''--_-.---'-''-'''---- � .. -------'--------'----'r---------'-------'---'---''^'r---------------------' ( | � | h� prepared this + �m *� � � d� in accordance' with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. (Plot plan. showing size of lot, location of m�in relation to wells, 6uildings, etc., can be placed on r'verse side). _-_ -FOR"=,,`=""".".-"S= ONLY -- .�/ ,� APPLICATION ACCEPTED BY ..�^_-`- ---_---' DATE--/'77nfZ0 '<4--i&------------ REVIEWED8Y-------------------------------------------- -----._--------_-____---' DATE-----__.-__-_-_-.. BU|LD|NG PERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE'-'''--.--''-�'-''�-'___-- Alt*r t|nns mn6/n, ,emomvmon6mtions:--------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------- --- -''' -''-------------� -_'''---''------''-'''--'''----'-''— ` ~ /- '----- — �`-'_� �~�~-'~�^�.-'---'------'---------------- ----------------- ----------------------- -------------------------------- -------------------------- ------------------------------ --------- ----------------------------------------------------- ----------------- ------------------ -------------------- �---_------- --------- -------------------------------------------------------------------------------------------------------------- ---------------------------------- �/_F|N/\L INSPECTION 8Y��.�'\=�� Ooto --'<� �- �l ~-'--'-'-�-'__' � SAN JOAQU|N LOCAL HEALTH DISTRICT /m south Arneric= Street 300 West Oak Street /32 Sycarn*re Street xw North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2m Revised u'5, ,,.o,. ^