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FOR OFFICE USE: <br /> 4M <br /> Permit No. <br /> ............ .. . PLICATION FOR SANITATION rcA <br /> IT <br /> .............."........_._...."".-.--•••"...... <br /> ....................... ------- - <br /> (Complete in Duplicate} Date Issued PAO/ <br /> Year From Date Issued This Permit Ex fires 1 1 e q _l So-06 <br /> construct and inste I the work herein desled- <br /> Joaquin Local Health District for a permit to <br /> ............ n <br /> p—plication <br /> i�ati�n is hereby mocle*)4116 SO <br /> is made A CAP4ncg with county ordinance No. 549 <br /> This application <br /> D.L ........ <br /> I.q _2 -7- <br /> JOB ADDRESS AND LOCAT1ORA4J4j­"5:r..0-F' on <br /> Owner's Name....--�_ <br /> �j_.Aff-Ar----------------------- -----—------------ <br /> _.Ej,97-4P.A)------5.4... .12,�12,".F..................................................1 --- <br /> All -aLTEB.....jjk�_ ................................ Phone._........_....-------------- <br /> re's <br /> Can ---------------------------------------- Other WILAIMOR <br /> tractor:s Name...CWbAlJW&JV Trailer Court 0 Motel 1:1. d,*WP) <br /> installation will serve- Rlidence 4drtmOR4';L0u-s0 C] Commercial 0 ........ Lot size ................................................*........... <br /> ribehf bedrooms __... Number of baths <br /> 4Numbe-r of living units Nul <br /> C1­ At I -pr Depth to Water Table <br /> m limu '+y Private 0 Clay Loam Cl Adobeo HardpanO <br /> Water Su`ppjy-4?4blic,;!,te "I ay 0 <br /> .40, 010 Sandy Loam 0 <br /> -S -tl_ e&+h of V;4JI. ❑isan rHA/VA: Yes 0 Nan <br /> Character,of Salo a dep h of 3 cfj6n.��yes <br /> 11� -rN ru <br /> 4 ` ow-_-Onst <br /> previous Application Made` 11f Yes date ....... <br /> TYPE OF INSTALLATION! AND IFICATIONS: <br /> it Q , . 6 available within 200 fast.) <br /> (No septic tank artcessp llpetmt a if P Uc or is <br /> mt 41. Distance 4;om foundation...) ......,,Material <br /> Septic Tank: Distance fr neare a <br /> A " i enfs .............size. -Liquid de0h------ . ..........Capacity...jqgD <br /> No. comps � to nearest lot line._........... <br /> ...........Distanci <br /> Distance from founclafion..1,0 <br /> D'ii�,i DisfJce f nearest we I. <br /> . .....­ I...........Width of trench ..........------ _Z <br /> sal Field- of each line------ Of <br /> A&.— Num-Cer of lin .......�Length .............. <br /> th Of filter material.... length...... -------- __9 <br /> ZI ftj- _.tffilt ........DOP <br /> ype <br /> jr Me n as+lot line............... <br /> from foundation......._...........Distance to near <br /> ........................ <br /> to nearest ---_-­---------------Depth�...... <br /> Seepage Pit: DistanceiF <br /> NumbeI — Lining material.................................... <br /> r o-C .. ..... Y. -----_--------------size: Diameter <br /> 11 1 TIM ��StZrzza� r *Foundation ............. <br /> ce K. I '4641.�......... . if apacity ............gals' <br /> 0 <br /> Cesspool: Distal I am P arl'; IT .... .............. <br /> ft9fts. Size..-Diam I te1.._i-----.......... <br /> '4� <br /> (3,r a <br /> ft.0.111 . ...............Distance from.n rest b,uilding... <br /> D' t Ice from st well...1__.- .................................................... <br /> Privy: ....... ..................................... <br /> ton oilsTta ce stilot line__...... ........... <br /> ........... ...... <br /> ids ibs)-" ..... .................................................... <br /> ----------- --------- <br /> .................et------ .. <br /> ............ .......-------------_--------------------- <br /> -------------- ...... <br /> .......... ...................... ............................................ .............................:........... <br /> ...... ...................... My <br /> accordance with San Joaquin &n� <br /> .........I I . ....hereb certify .1 have p4separed0his application and that the work wifffbe done in <br /> huin Local Health District. <br /> id_­­,nAj�sAmd.re.9'@atiOn5 Of the San Joe jxllw�mt)4 <br /> ordina L_(Owner-andjor ContraCtOrl <br /> 24, <br /> . . . ........................... <br /> can 1; <br /> . • ..................... _e_�Ieca�an r�eve�r;S;9�51 IS <br /> 1. - of system in relation+0 we <br /> (Plot P BY f. 10 'tion �u,buildings, at, <br /> plan, showing size 01 R DEPARTMENT USE ONLY <br /> - ------------ <br /> DATE..... <br /> APPLICATION ACCEPTED By.....IV--.... ..................------- <br /> f <br /> ...---------------- <br /> 11 ....­....­­­­........................... .................... --------- <br /> REVIEWEDBy - ---------1.............i........ ............. ...... <br /> BUILDING PERMIT LD -,j -01 -. ... -- r .................. ................... <br /> no <br /> 0, <br /> re_ <br /> 10, <br /> Alterations and/or rec97 <br /> A _ . .............................................. <br /> Alt-, -I- ----•------•"............ .......... <br /> I I..............-------------------- <br /> . ............................___.......L".-................ ........................................................................................._..................... <br /> ..........--------....... <br /> ­.......... ..... <br /> ................. ... <br /> ­-I...............4........._..........1-.................. <br /> . . . .........:........... <br /> ...........T................... ....... ........... <br /> FiNAL_INSPECTIONI BY:....V ............ <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 124 Sycoinom Proof 205 WOO 9th Sft*&t <br /> 130 South Amwitt"'Sh's" 300 Wait Oak Sim, Momota,California T,,,,colifornia <br /> Stockton,Calliomia <br /> me","to 9"'""Co,so 4*00 IL <br />