Laserfiche WebLink
� <br /> APPLICATION FOR SANITATION PERMIT ' <br /> inDuplicate) <br /> . <br /> o|�ut is hena6v ma6o to tke San Joaquin Local H D|��cf for o permit to construct and install the wnr hherein6described.' application'�~ i/ ' .6oincomp|iuncawithCountyO,dinnnco No. 649. <br /> This <br /> Owner's .,...-------- <br /> - . <br /> | ' ' '--' <br /> Uqn+mo+o/o N ___-___-_' <br /> _-_-_-__'-_-_-_-_--''Phone <br /> ------------------------------------- <br /> Installation <br /> -'_-_------'----''----'- <br /> - <br /> \���n w0 serve: Residence ����� House 2Cnmmmrciio| 0 Trailer Court E] Motel E] Other E] <br /> Number of living units: V1 Number of bedrnomsZ Number of baths V1 Lot oize.- - - -.- <br /> ----_---. <br /> WutevSupplv; Public system -m"'Community system 0 Private [I m � ur6pon <br /> Character of ,oY| to a depth mf9emt: Sand [D Gravel [j Sandy Loam EClay Loam F] Clay [ ~ <br /> [� <br /> TYPE OF INSTALLATION AND SPECIFICATIONS:/ (No septic tank orcesspool permitted ifpublic sewer ioavailable.within 200fawfJ . <br /> ` <br /> Septic^�la'nk' Distance from nnunas+ well ~ --Distance f"'" foundation '-w'__-_Mo+ariuL. <br /> -- <br /> �� d � «� S��. Liquid dept._- <br /> No. of compartments <br /> -- <br /> ' Lining material <br /> ui. . . �� <br /> --' : Distance from nearest we|L-_-:---------Distance �o foundation-- Size: Diameter---. o+6 . - <br /> Pivy' Distance from nearest well-------------------------------------------------Distance from nearest building <br /> -, <br /> -------------'--.----_- <br /> from foundation <br /> . -- <br /> tion-10 ---Distance to nearest lot line----- <br /> line <br /> Number on lines-------- -----------Length of each ---- <br /> ./,- of filtermaterial <br /> 'em ' /or rep <br /> \ --�- ----''-----'---- I <br /> ! have a <br /> ,�� �nap = =, ~ .~ be -~_ --r- �� Joaquin <br /> -- <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> � <br /> . <br /> \ ' � - <br /> -----__.-___- <br /> -_-.-'-- <br /> °'`- ---- ---� +'' o-' ------------------------ <br /> (Plot <br /> -_--'' <br /> (P|mt plans, showing �zomf�t. location system in relation to wUs ��|6�mg� etc., must 6* filed with this appUc*tion). <br /> FOR DEPARTMENT USE ONLY <br /> � DATE/\PPL|CAT|{>N /\CCEPTEDBY ��= _ .-----.���_-----_-.. ---' __-��������������� <br /> ---------'- - ' E_. -..� �h�.���----------------- <br /> BUILDING <br /> ` s�-�' -- °"' ''' --'' ----'-� <br /> ---------------- <br /> REVIEWED 8Y .-__-_----_`_-'_. ._---__-._---_. <br /> '----'''--' DATE -------------------------------- --------- <br /> PERW|T ISSUED-___--'-'''-_---'-__''-_..'''-'-_'--.'''''-- -__'--__-' <br /> —:=-� "-----' <br /> ----------------------------------------------------------------------------------------------------------c'_---------------------------------------------------------------------------------------------------------- <br /> _ \ <br /> .. . � (� FINAL INSPECTION DY�� . <br /> ----------- <br /> PERMIT N ''-_ |SSUED � - �� � _ . <br /> Date--------------------4 �''---'----'----' ^ <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> ' <br /> 130 South American Street <br /> Stockton, California <br />