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APPLICATION ' - . U��Il��� AOR SANITATION PERMIT <br />(Complete in Duplicate) - <br />Application is hereby made to the This application is made in compliarice with County Ordinance No. 549. herein described. <br />San Joaquin Local Health District f-, a Permit to construct and install,fhe work <br />JOB ADDRESS AND LOCATION_ X1 <br />lsf <br />Inst <br />tion will serve: <br />-'L-�= <br />'-�--�"p*����� Commercial l��Court Residence <br />Phone---- <br />Number� ��'�� E] O"nv' <br />WaferSupply: g units: ft Number of Number of baths - Lot size --- <br />Public LJ Community system Ejpr'-'h~ <br />Character mfsoil to a depth of 3 feet: Sand Ej � <br />I »��� - <br />Sandy LoamO Clay Loam[j Clay El Adobe Hardpan <br />TYpG OF INSTALLATION AND SPECIFICATIONS:,�] <br />(No septic tank OF Cesspool p�FrniMed if public sewer i, avaUo6/n within 200 feet.) <br />fe _^\SeP+|cTunk: Distance from na*nyof well ~ Distance from foun6u6vn_..m=-~__Material'Nr No. ufcompartments ---'°2 -'---'C«P�ci+Y-'-�'� ''Sizo ^J74'%°'jC Liquid <br />"=d'eP`+�h�-Cmsspou/: Distance from nearest well ------ Distance from t"«n6o+ion--'-- <br />'- <br />' <br />_ <br />-F] Size. Diameter _____-__''-_'-- Depth__------'-' -' Lin/ng m�+e,�------------------------------------- <br />Privy: <br />_ '-'--'-------- <br />'",p Distance from nearest- well ''''-----' <br />EDisf ncefo nearest ]of line� _ <br />~-^--��~--!-'---''—'' <br />Distance �f�n�zm�nearest building __-._-°_�_^_~_v..__-'_-�_ <br />-_'_ <br />SPit: Distance to nearest well ----------------------------- <br />Distance <br />----'--' <br />la ion <br />Number of <br />Didn �w--'~-'-'-''^�''���8^�''''D� )PJe_. Dis,'�oo�� mneom,m`D'~'~` " ~�---- ------------------- <br />Number <br />----'- <br />Num�v, of |e. ' 9_ Distance to nearest�t|�m��--~^v^"'"""n line V6f of french .�P~' �°------------ <br />Type <br />''-- <br />� <br />� <br />T"o» of filter mofe]�-o--| Depth ~-^o+-._�.�_+~ar_m.-o-+_or_�_------ <br />-Remodeling <br />.-. <br />- <br />-RemoJokn and/or repairing / <br />,ordinances, State laws, anduules and r�gulafijons of (Plot plans, showing size of [of, location 6 system in relar I _;_4 -------- <br />.----------------------------------------c________��, San --�--'-----'------------------------------------------ <br />------_------_-_--_-_--_-_-..._--_-.._-______________'----------_-__.__.____._______ '------'--'-''''---''------''----'__-___ -'---''--'-'---''------'-_...{ ^Date <br />SAN <br />~ <br />. - LIN uou/m-| <br />|30��u+hAmer�mmSfme+ <br />ES -9-2M 9-50 W�1639 <br />