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FOR OFFICE USE <br /> APPLICATION FOR SANITATION PERMIT Permit NO. . ..-_ ._... ..-- <br /> (Complete in Duplicate} Date Issued I <br /> This Permit Expires-1 Year From Data '.fu. <br /> Applicafie'- s hereby made to the San Joaquin Local Health District for a permit to ca:nsln I end install the w014 heroin descn'be <br /> This application %s made in compliance w7th County Ordinance No. $49. �/ / <br /> JOB ADDRESS AND LOCATION . / • !�.• ' `f"- - ' / "" <br /> Owrei s Name ! (�.!•-r !• / �_ a.. I� - . <br /> t:.�• . / . -...{.. <br /> ��_ <br /> Address...... L : ... Plano..... .l..... <br /> Contractor's Nems <br /> - <br /> Insfallaf'ron will serve Residence C) ApartmentHouse ❑ Commercial E3 Trailer Court ❑ Metol ❑ Offset, <br /> Number of living units: .. Number of bedrooms - Num!•er of baths[ 6At t<slse . /�/-...w,'�.//.'(.--•'•-. • <br /> Water Supply: Public system ❑ Co.,.munity system ❑ Private)( Depth to Water Table felt <br /> Character of a9 fu a depth of 3 fast• Sanc [3 Gavel (DSandy Loom❑ Clay Loam 1] Cloy❑ Adobell HardpanHardpan <br /> Preview Application Made: I I I yes.date 1 No ❑ New Construction: Yes X Ao ❑ rNAIVl NO❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONSI f A • O <br /> bpe sewer it ewon"within 100 W.) <br /> )Ne septic lank or eexpeot paredilei If Pu <br /> ;;apt c Tank: D;sleace f•om nearest wet 1! y Distance floor iolms:elion / • Maferid <br /> •�y_ f 1 X•/ Liquid depth <br /> dep !/ ` CapaCil•../.s�<< � <br /> nI :omparfma-Is -% Sire r <br /> �;spoal Field: Dirarce from "sl well '•�• Y ristance from foundation A.! �,._Dittenee to taeretl b1 line ' <br /> Number of lines .2 / Length of each line/ .a * L a Width of }reach !q <br /> Nf 'I ? <br /> lypa of I Iter mate•ie ':A rrl Depth of filter material 'total torsgth /.fie. r <br /> Seepage Pd: D:tfnncs to nearost -0 /f<. Distance,lege 1 atierr pisen,re to neares!int Gee a <br /> r i <br /> V Ilumb er o( p.fs ../ Lining nulerial. h f :ue' Die•sseta. Depth s <br /> 'sp Distance I.om "-We • wed Distance 4om loundat_•n L.ninq me!Miat <br /> Cesspool: Dept Liqu d Capacity gals. <br /> C3 ;:e: Diomrtar <br /> p.Vn<o from nnarost building <br /> Piney: Distnni.e S'0" nNest wall _ T <br /> ❑ Dista•.ce to neared lc• tiro <br /> Remodeling and,<. ...c• . <br /> i <br /> I herebycertify <br /> ify that <br /> and halo <br /> Panda Od this application ef the San and <br /> thein wankcal wbl bdone in District. accord~ with San Jepuin County 1% <br /> ordinances, SS t <br /> / t \ , e s ,�', •. s _ low"and/ser CorrMactorl <br /> f— (rte) <br /> et/rwer+e a1de� <br /> ((Plot pen, shewinq sirs of W. ecdien of system In rolatfi]]n M Wath. bdldbgs.eM. eon M paced <br /> - <br /> __ <br /> k DEPARTMENT USE ONLY _ <br /> APPLICATION A=PTIJ 81 %z DATE <br /> DATE <br /> REVIEWED By DATE - <br /> BU;LDING PFrt41Y ISSUED / ! v %i Cj.F /f••r _ _-_ <br /> Alferatiats and/or recemmenLddlens: > > <br /> / SAN JOAQUI': I.00AL HEALTH DISTRICT <br /> No w.v a.Y tn..r use tier.•.snow, los w..r ora S..1 aNnn.n a... ra.we..Get«.� r.•.. [.�a«-r <br /> l.Icel l.r-a <br />