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»��U��T}�� F�� `hj�T��'�� ^ I�"r� No. | D �� h�mmp|ufo �n Dup|��fn\ ��: �-^p ^ ' i ' Do+o issued ....................... L. hereby made to the Son Joaquin Local Hoo|H` District for u permit toconstruct and install the work herein described. This application is nna6a in compliance with County Ordinance No. 544. JOB ADDRESS AND LOCATION ^ - -- -- -'r'-----'---- - --- 11 Installation will serve: Residevnce)K Apartment House Commercial 0 Trailer Court M t I J-] Other E] Number of living units: __/--- Number of bedrooms .2.- Number of baths /.... Lot size Water Supply: Public system X Community system bI Private E] Depth to Water Ta e Character of soil to a depth of 3 feet: Sand [] Gravel E] Sandy Loam E] Clay Loam [:] Clay Adobe R--�Harclpan Ej Previous Application-Made: Yo, [] No []~~~New Construction: Yes 0 No A/VA. Yes El NoET-__' TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer isavailable within 200 feet.) k Distance from nearest well----------------- from foundation--------------------Material -------------------------.- No. of compartments.............. ...........Size----------------------.........Liquid 6ap�6------_--Capacity-..__----' | Fiel Distance from nearest well --- -----Distance fn,m foundation--------------------Distance to nearest lot line................... Number of lines---------------- - -------------Length of each line---------- ...................Width of french............. --.---_--. Tvon offi|tenmatorioL---.—--Dapth of filter material---_---------_-------Tot | length...............01 .......................... Seepage R+: Distance to nearest °e| -' Distance from foun6 Distance to nearest |o+ |ine_.7��7'.._ Number of pits...../.............Lining mo+eriaL --'Size: Diameter.��-^r--Dap+h..,Z.J----------------------( Cesspool: Distance from nearest well -----Distance fron foundation....................Lining matoriuL-----'''-_. F-1 Size: D�m�ec_----------Doof ---_'--''-----'—'Uoui6 C�poc�y '---__''_'go�.yu � ^ �{ Privy: Distance from nearest well----- --------------------------------Distance from nearest building------ ..................... . [] Dist nco to nearest lot line.-----------------___---_---'_-----------------.. » Remodeling on6/or repairing (describe):--- . r— _-_-'-_.__-----.-_—_' ----'-----'----'----------- ---------''��'---------_-------'—'-------'---'' . ----'--'------'----------- -------- ...................................................................... -------'-- -----_--._--'-_-_----_-----______-'---._---._.__--_-----'----------------' accordance with San Joaquin County \� ordinanceyllale laws, and rules and regulations of the San Joaquin Local Health District. � (Plot plan, showing size of lot, location of system in relation to S,L6uildings,&%., can be placed on reverse side). FOR DEPARTMENT USE ONLY ~7 .n � APPLICATION ACCEPTED 8Y--^�../��^~^-'---------------.------------. D/\TE---^=.�-��.*. ---------.. REVIEWEDDY---------------------------------- ----------- ---------------------------------------------------------------------------- DATE----------_,L-------_-- DU|LD|NG PERMIT ISSUED.............................................................. DATE ----__----_-.__'_-- AKw,afionsand/or recommendations:''_--_-_.----._---_''--.---.--_-__'______-_'_'-_'_-_-----_-.` --------'--------------'----------------------------------'------' .......... _______ ________'___'_______________._____ .................................... .. .................................... .............. _--------------------------------------------------------_------ FIN/\L INSPECTION-''B_Y--�� - - -.. -1\. ~~..,............ Date.........w-c -'3-5�_ ----------_-_- SANJCAQU|NLOCALHEALTHO|STR|CT /am South American Street 300 West oak Street |sm Sycamore Street nw North ~r' Street Stockton, California Lodi, California Manteca, California Tracy, California