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^ APPLICATION FOR SANITATION PERMIT Permit No . ' <br /> kCommletm in DwoU��f� <br /> - ~ � ' ' Dufa �suo6 _�/��/� u_ <br /> - _ . � <br /> '- `r <br /> /\ ereby,made to the SanJoaquin LocalHealth Dis � <br /> � ctfor upermit foconstruct and install ^ '~^^~'~t�o~u, � !'' described. <br /> |mapplication is made in compliance with No. 549. <br /> r'V <br /> JOB ADDRESS AND LOCATION---. TF-Y--�� <br /> T. -------------------------------------------------------- <br /> �� ° -_- _'----.-__�_---_-�-- <br /> [�wno,o Name-------------- <br /> Address-___ <br /> ^ ^ --------- ' <br /> Contractor's Name-------_-r�./���JF__---._------------'_--.-- ^`------------ Phona_ --------------- <br /> Installation <br /> _'--'|nstaUaGon *;U � Residence ` l ~ <br /> �� on� � ��r�a� H�oo � Commercial � 7�i|or ��� E] Mdn| El Other Num~�r � fiving u;~: .���� Nu���,���o '� Number-of baths Z ��~63��. � - ~ . <br /> Water Supply: Public system ElCommunit- system [] Prufe'N Doo+ to Table ~--''�-'-'�'-' <br /> Ch soil,� to a depth of feet: Sand � 6��vo E] Sandy Lomm' Table{]oy Loam [] --m> El'- Adobe []_ Hor600n'[] <br /> Previous Application Made: Yes F] No IN New Construction:. Yes g No [� ~ <br /> TYPE Of INSTALLATION AND SPECIFICATIONS: ^w * 'x <br /> t-� <br /> (No septic tank or cesspool pe�miffecl if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest Distance f om olund# <br /> ,7 Disposal Field: Distance from nearest well_._.%�'17-Distance from ounclation--- Distance to neares"t lot ll'jne'-'- <br /> Seepage Pit: Distance to nearest well------ -----------.---Distance from foundation--------------------Distance to nearest lot line_--------- <br /> -------------------------- <br /> ���_���� �x, <br /> El Distance to nearest lot line <br /> I hereby certify that I have prepared this applic�ifion and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and ruRZand regulations of the San Joaquin Local Health District. <br /> (Plot plan, showing size )1ot, location of system in relafi;n —fo wells,-buiildin_�Fs,'efc., can be placed'on reVOrse'side).4­ <br /> FOR DEPARTMENT USE ONLY <br /> -----------.----------.---------------------------.---.------'------.----------_.- ' <br /> -`._--- ---- - ---- _-_-_----------------------__------------_-___.-_-_'___---.-- . <br /> -------------------------'--------'-'-�--'''''--''''''---'''''r^-'-----''�''--'''-------'`'''--''''------'''',----_______ � <br /> ----_-------------.-_----------------'_'_---.---------------__-_-------_' , <br /> FINAL INSPECTION BY:. -�'----''-- --�� ________--__---________. � <br /> SANJOAQU|NbOCALH64LTH DISTRICT <br /> /uv Sv"fh American Street 300 West Oak Street mz Sycamore Street - ow North "C" Street ^] <br /> St*"Ho". California Lod|, California wanw"°. California Tracy. California � <br /> ES-9-2m ; x=*°a W-z/oo <br /> ` . <br />