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` <br /> . A ��* � <br /> �p����T|��N FOR SANITATIONPERMITPermitNPermit <br /> _ Y <br /> __� (Complete in Duplicate) _ <br /> ....Du+o Issued <br /> i� 6en,6v made to the San Joaquin Local Health District permit +ocon inmnUthe work herein described. <br /> This �d6n <br /> applicationi J i |i k CountyOrdinance� No. 549.­`JOB ADDRESS AND LOCATION. - - ------J?Z_- <br /> Owner's Name------ ­- ---- -------a-- - - - --- --- -- ---------i_j ..... .......... I`t4Von..................................... <br /> Installation will serve: Residence E] Apart ent House El Commercial Trailer Court ,0 Motel El Other 0 <br /> Number of living units: -------- Number of bedrooms ------ - Number of baths .4o--- Lot size <br /> 7Water Sup : Public system E] Community system [3 Private N Depth to Wat _able w,_Ojt�'� <br /> Characfer of soil to a depth of 3 feet: Sand E] Gravel F] Sandy Loom[] Clay Loamb-day El Adobe C1 Hardpanji"' <br /> Previous Application Made: (if yes,date---- ---- - --- -_) No [:] New Construction: Yes 0 No [] FHA/VA- Yes No C1 <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Inptic Tank: Distance from nooma well.................Distance from foundation-------------------Material --- .................................... <br /> [] No' of compartments - .�Size. . .LiqvidJe.wk _ _ Cupo6ty__ <br /> _____---- <br /> ~ <br /> D' \ G�J' Distance from o�ur°,+ *�|L'���-'Di�unc� from foundation-------- to nearest lot <br /> . � �� � � <br /> Nvm6e, of U x -.-.Length of co lof trench>� <br /> Type offilter ma�,�i Depth of filter material �F........ �| length ��^� ' : <br /> _, __� � __ ".^"��� ., ,"�.,". <br /> ~ Seepage p�: Ub+onco to ne^m,twex--.60.a- Distance , <br /> Number of p��--J/---.�ring ta� | -S�e: U�mn+o,-_.�1��-�Denf h.�w@���-----_. <br /> ��Cesspool: Distance from nno�� °mU--_--.Distance 6om 6mm6u6on------'Un�gmuta,�L--_-_---__--- <br /> ^~ [ Size: Diametar - Depth _ Liquid Capacity-------------------_-------guls. <br /> Privy: Distance from nearest well------- ----------------------- ........ -'Di,+uoco from nearest building------------------------------------------ <br /> Distance +o nearest k* |/^o----------------_----'------'----'----------------- <br /> _ � <br /> � <br /> -~ -' _ _----_-----__-__--._-_-_--____-_--.__---_____--_'_-_'--__''_--'--__'---- <br /> ' —�I hereby cerfify that I have prepared this application and that the work will be done in accordance with San Joaquin Countyordinances. State <br /> laws, and rules and regulations of the San Joaquin Local Health District. ` <br /> ~ ' -------------'«=`,=� "'~v~' Contractor) <br /> `- ' <br /> --- ..~ --------------------------------------------- -----' <br /> By - <br /> (Plot plan. showing size of lot, location of system rela .on to wells, buildings. etc.. can p���enpn rove,� side).' <br /> .� <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY' -- ------------------------------------------------ uA/�.-z..--- .e�.��.��_-------' <br /> � E � <br /> REVIEWED BY------------------------------------------ DATE <br /> BUILDINGPERMIT ISSUED---------------------- --------------------------------......_ ---------------------------------- ur,/E---------------------------------------------------- <br /> Alterations and/or -__ <br /> '- ..............................------------------------------ .................. .............................-------_-----�_--`--'_-''__--_----------._--_- <br /> -_----__---_''-_.'-__--__-------- ---- --------------------------------------------------------------------------------------- --__---_' <br /> '--------'-----.--'-----''----------------..-r--------''-'-------------- <br /> �~ - ......................................... -------------------------------------- ....... ........... ...................................... ..............................----------- ---------------------------- <br /> _' <br /> ./ -�_~_ <br /> FINAL INSPECTION 8Y�. �� -------' Date........... <br /> BAN JOAQU|N LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street 1o*Sycamore Street 205 West 91h Street <br /> Stockton,California Lodi,California m�=���=� Tracy,California <br /> -- p . <br /> "" 9 ""°"""S-59 "" °'^. =°" ^` <br />