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� <br /> ~ �\ /9 <br /> \ ./- ' <br /> =*� ' <br /> , <br /> | 4 APPLICATION ��� SA���T �� PERMIT � <br /> ' =^~_ .�� - . . `SANITATION <br /> n , i (Complete in � <br /> _ <br /> Application <br /> v ~ <br /> is hereby �na'd6 to the Sun Joaquin Health District for <br /> o permit fo construct and insfoUthe work 6onJn described.application is made in compliance w�hCouyOr6�ooco No. 549. � <br /> JOB ADDRESS AND LOCATION_--.. ' \ <br />' <br /> {}�ne�� Num / " ~/ '--'---------'''--''-- ' <br />' e--''~* -���4�����'�'�����-----------------' Phone----�/ 0 7 �» » <br /> ----------------- <br /> Contractor's Name <br /> Installation will serve: Residence M/ 4-7-'l- - <br /> ,�parfment Hou Commercial [] 'Trailer:Court [] Motel El Other <br /> El <br /> Number of living units: :k Ournber of bedrooms CZ Number of bathsR- Lot s ize------- -------------------------- <br /> Water Supply: Public <br /> stem <br />' -- Community system ^~ Private' �"�^ <br /> Character of soil toedepth of 3 feet: Sand El Gravel E] Son6yLoam 0 Clay Loam Ej Clay El Adobe�� Hardpan El <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> ^ ' <br /> i (No septic tank orcesspool p*rmh+e6 if public sewer isavailable within 200 <br /> �00feefJ <br /> Septic Tank: D|o+nncu from nearest well .-------Distance from founduf�on--------------------Material <br /> '--- <br /> LNo. of compartments -..__--Cmpnc|�� . S|oe- --------'---- <br /> ----~ <br /> -------------------------------Liquid -_--__. <br /> ~e,n^uv : u'stanoa tmm -�^ <br /> ' <br /> nearest we|L__-_-D�f n»e from foun�af�n �~ Uning nnufo�oL_ <br /> �� Size: Diameter-.__._—_-----_-Deot ------------------------------------------------------`-- -------'-- ' <br /> Privy: Distance- . rce from nearest weK-________ Distance �m ,�p� �i|6�g <br /> [] Distance to nearest �t |� ^ --'-'' '-----''-'--'---�, <br /> ------------------------------- <br /> Seepage Pit: Distance t'o' nearest well------ - Distance Aforn toundation----6-S------Distance to nearest lot line <br /> Disposal Field: Distance.fr'orn nearest we�l------------------Distance from foundation--------------------Dis.tance to nearest lot line----------------- <br /> Remodeling and/or repairing (describe)---------------- <br /> I hereby certify that I have prepared this application and that the work will be done in a-c-corda--c----with--S-a-n--Joa qui-n'--Cou-n-ty <br /> law nd rules an cf. n 0 <br /> ordinances, S��a—vvs I rules A-a regulations of the San Joaquin Local Health Distri <br /> ...j��. <br /> -------------------------------------------------------- <br /> �Qw er and/or,Contractor) <br /> (Plot plans, showing size of lot, lo cation <br /> of sva----------------------- 6uildings, efc., must be filed with this application). <br /> U, rn in relation to wells. <br /> FOR DEPARTMENT USE ONLY <br /> "".uux~«� PERMIT mxo�u--�_- ��---------'-----' <br /> AKerat�nuand/or recommendations:-�--'.------.__-. _--.-'_'---'--'' "'`'�--------------'------ <br /> ____._______.____." -'----''-----_----------'--------'- --v' <br /> -------------------------------------------'�__''____.--___.__----__.__-.-'-_''-__'-___-.'___'''----__---_.'__-- <br /> ---...--_-__--__-__-_-�'--___-.-_-''__''-_.'''__.-__''-__-''__-''---_-_____--..__----._.- <br /> ____________.___.__--r-''_''---''-------''-_-''---''__--'-_--''''-__.__.''_-__.--'-'________ | <br /> ' ' -__-_---.-__-- ------------- <br /> ------- <br /> PERk�|T No.--:721 |33�ED � -/ �� - �-7 k"' <br /> - ..__- � -_�--_--__---_.(Dot� RN/\L INSPECTION 8Y�-' ��-��/`/ <br /> �7~- -'--- <br /> uo�� <br /> U .__ ��.__---------' �,.�'________. <br /> � SAN JOAQUIN LOCAL HEALTH DISTRICT ` <br /> � /30South American Street ' <br /> � w 9.50 *�/639 � Stockton, California <br /> � . <br /> / <br />