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FOROFFICE <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. S49. <br /> JOB ADDRESS L ATIO 419 <br /> Installation will serve: Residence Trailer Co�rf [] Motel [] Other <br /> Water Supply; Public system 1(j�<Community system <br /> Private 1-71 Depth to Water'-TAble ft. <br /> Character of soil to a depth of 3 fe�fi, San-d [] Gravel.Q.. Sandy Loam E] Clay Loamt.o.' Clay E] Adobe Uq-<ardpan C] <br /> Previous Application Made: (if yes,.date--`--L----------------) -�o 0?""N-ew Construction. Yes [-] No [4,`1FHA/VA; Yes No Z--1kN <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Disposal Field: Distance from nearest well....!rr=-------Distance from foundation.../P----------Distance to nearest lot line...4.7?L.... <br /> Type of filter material. -V <br /> Seepage Pit: Distance to nea�est well------ --—--------Distance from foynclation---..'z-e,?..1'.,Distqnce to nearest lot line--- ......... <br /> ---- '---''--''--''----''--'--'''-----'----'-'--'—'--'—'-------''------'----'—'— <br /> '-----------'--''--'-------'-------^------'---------------------'---'--'-----'—'' <br />' ----___-'—'_--_—_--.—_..—__.--_—'_______---__--.---_—_—___--__—_-__--_—_._-----.. <br />` ' hereby ~, that ' '~`~ prepared <br />� nnzmmn==p State laws a d rules and regulations of the San Joaquin Local Health District. <br />� (Signmd) ----—- -------- -- ---------------- ----- (Ownatw2di3v Contractor) <br />' ' <br /> -,'........................ .__. �Zwells, <br /> .. ~' _---- <br /> �� ��. �� wf �� ��� � ���� ��p ���� �� �� k� ���� nw �v�� o�m1. . - ' �^ -- .� <br /> FOR DEPARTMENT USE ONLY <br />� <br /> 7— <br /> APPLICATION ACCEPTED 8Y DATE---- <br /> REVIEWED <br /> RGV|GWED 8Y'''-----'---_'—'' .:....................___'- DATE--------__-__--___.__ <br /> BU|LDINGPERM|T |6SUED--.'—''-----'--'''—''''''—'''---.-'—_.'—''__-'—' DATE_-''--''--''—''—''—'______ <br /> -------------------------------- <br /> V-------------------------­ <br /> __-----,---.,—_.--- ~_- <br /> FINAL INSPECTION BY:-...j-1.- - ------ =y...^� .'�� w�----_--- <br /> ~ SAN JOAQqIN <br /> vmwSouth Amer[can Street u0oWest Oak Street v2*ovcarnor*Street- \ mn5West 9th Street <br /> Stockton,California Lou/'California Manteca,California Tracy,California <br /> ," 9REVISED o'"pwm "'", ATLAS -r <br />� . <br />