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A[,. ICATION FOR SANITATION PERtv.-,-, Permit <br /> v / - <br /> � ' T�� ' ' Duplicate) Bis Permit Expires 1 Year From Date Issuedum |qve6 ------ -�_.Application ^ / <br /> is hereby made to the Son Joaquin Locu| Health District for a permit to construct and install thwork herein described. <br /> This application is made in compliance with cy' ntt Ordinance No. 549. <br /> JOB ADDRESS AND LOCAjIO_N <br /> - --- ^ Name----- -__-.===���'��c�'. --------------------------------- ---------------- --- -------------------------- ----- . Phone.................................... <br /> Address-------------- <br /> Con+mctor's Nom o- -�[-'/------------------------------------------------- Phone---............................... <br /> Installation will serve: RedJono, [!]- Apartment House 0 Commercial [] Trailer Court El Wuto| [] Other E] <br /> Number cfliving units: -[- Number ofbedrooms -,Z_ Number of 6uH`s /-- Lot ,bn -/��.�L��.��---_-___--_-- <br /> W�r ���: Public ��m [9 Community ��m 0 ��� 0 D*F� � Ya�' �h��._0_' ft. <br /> Character of soil to u depth of ] feet: Sand [] Gravel [] Sandy Loam [] Clay Loam [l Clay [] Adobe Z1 Hon6puo 0P,e,inus Application Made: Ufves'6ote--- ----) No g] Now Construction: Yo, 0- No 0FHA/VA. Yes E] No P <br /> TYPE OFINSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool pu,mH+oJ if public sewer is *,oi|u6|o within 200 600+.) <br /> � <br /> S~p+ic Tank: Distance from nearest ~v| -.Di`tonce from fomn6ahon/��-' <br /> ''--Material_- <br /> - [�^ ^` � ����—' <br /> ,Disposal Field: Distance from nou,o`t well----------------- from founJu�on. /'L-� -Didnnco to nearest lot | <br /> Number of lines.---_-L-.. _—Long+ ofooc6 |ino''_70'-----------------------Width of french.. �Ly^ �- <br /> ----'�__''-_.- <br /> - Type of filter mute�oL�'�wt,_--'Dop+ of filter motv�uL!K!�----'Total length-- - <br /> Seepage Pit: Distance to nearest ~oL-'. �--'Distance from founJu6on ' '__Distance to nnoro, lot line `�~/ [ <br /> [�- <br /> Number of p�s--/-'---�n�g mo+a,Oi --S�o: Diameter.� 3�^ ' <br /> Dopfh - - '---' ` <br /> Coopoo: Distance from nearest well '-''—..-Distance from foundation------------------ mo+o,iaL- ` <br /> - ^ <br /> 171 Size: Diameter -- ---------------------------Depth----------------------------------------------------Liquid Capacity <br /> ' est_ - ng <br /> I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regula�f' ns of the San Joaquin Local Health District. <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> OR DEPA MENT USE ONLY <br /> - ------- <br /> BUILDING PERMIT ISSUED.-----�-'--- ' — .' - - c_- <br /> ^ ~ - -�-- <br /> A�er hvo; and/or recommendations:-, r ~' ~ c��-~- ^ /-� ' ... - ------------'............. <br /> ...................................................................................................................................................... --_--_-'_-_-__--_-__-'---_ <br /> ............................'.............................................................................................................................................................. ................................ <br /> ................................................................ ------ -------------- -----------------------------------------------------------------------------........................................................ <br /> ........................................ ......... ................. .................. ....................................... -'---...... ........-----------'---'----' <br /> - PINAL INSPECTION 8Y� 'Lx�� Date -'- -. ----- <br /> ------ <br /> _--_____ <br /> SAN JOAQUiN LOCAL HEALTH DISTRICT <br /> - /mSouth American Street ovmWest Oak Street ,mSycamore Street m,West",hStreet <br /> Stockton, California Lodi, California Manteca,California Tracy,California <br /> ," , REVISED "°, xw5'". ATLAS <br /> - <br />