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/ <br /> . � � � � <br /> APPLICATION FOR SANITATION PERMIT �� Pmrn"f . .. <br /> (Complete <br /> �°-T- <br /> in y <br /> ` '' <br /> Date Issued <br /> ^ <br /> T�plica4,ion is hereby <br /> made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> is application is made in compliance with County Ordinance No. 549 <br /> JOB ADDRESS ANf 1DCATION___/101A�,_ <br /> ---------------------------- <br /> _ <br /> ------- <br /> Contractor's Nomo----.- ��Ve~---------------------.------- Phone--------.-.--- <br /> |nohnUmtionwill serve: Residence ��/\po,hnonf House Commercial [] Trailer Court [] Motel El Other [] <br /> Number o{ living units: Y- Number ofbedrooms ---3.. Number ~fbaths ^^- Lot size � ��'^�.� ^�..'---.-.----.- <br /> Water Supply: Public system mmun�y ��m � ��� [� O�n� � ��r'�6���°� <br /> Character of soil to a depth of feet: Sand [] G,vvn| Ej Sandy Loam-E] Clay Loom [] Clay [] Adobe &~1Hurdpun [] <br /> Previous Application Made: Yes [] No V�~° New Construction: Yes [] No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: ~ <br /> /No septic tank or cesspool pnrmHfo6 R public sewer is available within 200 feet.) <br /> Tank: Distance from neomn+ ve|L_----D|stunce from foundation--------------------Material --------._-_-____ <br /> Nn. of compartments--------------------------Size--------------------------------Liquid <br /> � �ep <br /> fk . .Cup*d+y -.- <br /> nearest � , - <br /> D| | Distance <br /> ?* Number ^ <br /> ' ~ �D�stance from foundation Distance to nearest lot line <br /> Type of filter mnfor�u� . � ^........Total ^ <br /> |ong��--x�r��.�.------__ <br /> ��� � <br /> Seepage Pit: Distance to nearest waU-.�2��n&��..Distance f f ion-��s-- ^e to nearest lot kne.`�-- <br /> / <br /> Number of p|+s-'^�----.Lining mate,ioi�v�� iz�� Diumofvr. -------Dept h. -.� <br /> Coopoo|: Distance from nearest well-----------------Distance from foundation -----------------Lining material ------_--__ <br /> [� �zv: Diome+er --'-'--'-� �'-Dnot� '''-''''-_.'----''-'Uoui6 ' m�, !^ <br /> '��� ' --,--''-'''-'''--'~- <br /> Privy Distance from nearest well - ---- ------ ----------------------------Distance from nouresfbuilding'-''_--�-'__.---- ~ <br /> [] Distance to nearest lot line- ---------------.. - '---_._______.. <br /> Romodaing and/or repairing (describe):----------- ' ___.__________.__ <br /> '--_..__.___-_--__---.-------_._-._-.__.--'_.---_-_--_-'.---_---.__-_-'__-.. <br /> ---'--'---'----'-----''''----''-----'-''--''--'------''-''-----'''---''---'---'----'---' <br /> --'--''--''---'-''--'''--'--''-------'----''''-------'--'---''--'''-''----'''----''--'---'-''— <br /> | hereby certify that have prepared this application and that +he work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and V rules and regulations of the..San Joaquin Local Health District. <br /> system in relation to w <br /> (Plot plan, showing size of lot, locatioln 611s, buildings, etc.. can be place V-rverse si <br /> FOR DEPARTMENT USE ONLY \ <br /> ------------------------------------- <br /> ou/uu/nG rcxm// ISSUED--------------------------------- '''----''''-'''-'''--- DATE-------- ` <br /> Altw,mtionswn6/o, ,wcwmmnn6afiono:------ `_________._____._.____.____._. �~ _�J�-__.________. <br /> ._-.. --. -_-_'_.--_-------__--_-- <br /> '-''-~- 5a� '''--''''---''__.''''''-'-'_----'-- <br /> .-_---'�'. -~~.�-�~~~`-.^~~.-�^--_-.*-~—^-' ---__----__---- ------------------------------ <br /> ------------------------'�---'--'' _-' ---''--''. �'''-'''-'''-'''--''--''�--_''''-''-'---''-''--_' ~ <br /> «� <br /> � � � _� � <br /> FINAL INSPECTION 8Y:--� .-���-_-_-- Du��--�^�.��..�-�*� -'��-x�-----_.-.- <br /> SAN JOAQU|NLOCAL HEALTH DISTRICT <br /> /mv South *m=itm" Street ano West Oak Street /sz Sycamore Sfre°+ u|* North 'C' s*°w <br />� <br /> Stockton, California Lodi, California wmnh,= California Tracy. California <br /> - <br /> ,"_, ~~°^^,,,O, <br /> _� ~ / <br />