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r ' <br /> r0; <br /> APPLICATION FOR SANITATION PERMIT Permit No. .........._........... <br /> (Complete in Duplicatel Date Issued . . - .._._.... <br /> This Permit Expires 1 Year From Date Issued - -- <br /> A.pplicaKon is hereby made to the Sen Joaquin Local Health District for a permit to construct and install the work herein descrnoed. <br /> Tn,*s a/FjF��icQep}_, iijp�made/Gr/'n cc • r n h County Ordinance <br /> eNNo. <br /> -54J9s <br /> Jo AUDRESS N LC^Ct Tt N� ��G? iLs,( /`�^�L.....- _C��.. '--X7..... ...6 --.•_.'__�"`._ . � <br /> Own. s Na mc -rte-- F� �/f S S.E/? Phone.._. ...... s <br /> Addrers.- .. �--�+C 3 1b�- '�T. � IB/f/ /Jrf(i/ .l. - /�OOM. /1.G//.. <br /> ... <br /> Ccntredoc's Lara..• (,.Z'C _..,�s�PGGI.L't • Gss.n�Q� .. . .. Phone Z1F'�-•A�ZZ".- <br /> Installatien will serve: Re Jdcrce 0 Apartment House ❑ Commercial Ill .Gott ❑ Motel ❑ 9tthhler ❑]•/�. <br /> ?lumber o{ livinq_ units Number of bedroom. . Number of bath . o s:za .. .�� 0?^r•.':�_'P`..'��^[-.. . <br /> Water Supply: Public system 0 Community syshem ❑ PrivateX Depth to Water Table V419 ff. <br /> Character of sod to a depth of 3 foot: Sand ❑ Gravel ❑ Sandy Loam❑ Clay Loam❑ Clay❑ Adobe Hardpan❑ <br /> Previous Application Made: II' ye� dote 1 No Ly' Now Construction: Yes &--No ❑ FHA/VA: Yes ❑ No Cl <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> ( p ,or cesspool permitted if public sewer is available within 200 feet.) e-f <br /> No septic tank <br /> Septic T � �taoo� `ro,n m:,lrt::f ve'.I JO rDisfe�r/es from fo�/undafion.�Q. . .. ._�.-�/J <br /> C! c 'I mfine^Is a . r i2e.-2.�F�.S/• 7-Liquid dapth a/ Capacity...//�OOvls'i• <br /> Disease( j (` ;1nr { ,m nen'esf wv I S-40 Distance from foundation. ,DManco to nearest lot line. S_.. .... <br /> I- Length/ Length of each Gne/00' /00 Width of trench ..ZV. ... <br /> ft o 1•e"Al Si� -4l Dop}h of filter material /8 O Total length .. . -%Ill it .._.. � <br /> See <br /> , r . •a 0I ".Distance f-om f ndation 9.� Disteno oline s� s � _ 00LJn;nq material V� <br /> Size: Diameter 3 e Depth �S J <br /> Cosspool: '1 l• .,. -.f ,,. i Dafanco from founda Hon Un inn material .. .. <br /> ❑ Dap}h. Liquid Capacity gels.Z <br /> Privy: �` - �• '.' 1 DMAnee fro nearest hu�lding <br /> U •v <br /> Ren adoli�q n, _. .. <br /> I her,6v ce-tify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordieaners, S e laws, a/nd rules/ ndjegu!ations of the en Joagyin Local Health District. <br /> (Signed) <br /> Qt Ls-(cess/ af2GetJ�t/ •� (JOAw+er andl Contractor) <br /> By: 066 r' -(.ZG ti •...� (Title) /'If I I <br /> (Plot plan, showing size of lot, location of system in relationww ells, buildings, etc., can be placed o reverse tide). <br /> FOR DEPARTMENT USE ONLY <br /> A.G., i,-A•. . 1, .i. �.n' Z ( "'�i.-_ DATE <br /> Bi.•.ir1. [..l r . DATE <br /> Alterations And%er reeommr ndafioes: <br /> :. ':A!. J, j Date <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> I601 S a.. 100 W.I.On'Srn.r 124 Sy,mn.,.Sbof 203 Poor orb H...1 <br /> A..s•.- c.+'r,,.�„ lo• CuLlm+m Manua.C.:ilo.n:e r.asr Cablsrnie <br />