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- <br /> A <br /> ��PPLIC�\TI���� �FOR SANITATIONpPERMIT <br /> (Complete in Duplicate) <br /> Agplicafion is hereby mode to the San Joaquin Local Hua�h Districtfor a permitto construct and install the work herein described.n upp|icofion� ;ymade in compliance with County Ordinance No. 349. <br /> ' J[)G ADDRESS AND LOCATION------jS-/�U_th!nEP.81-Q/%M@x-/�f--- <br /> ��]'1- <br /> Owner's Name-------------------------------------- --------------------------------------------------------- -------------------------------------------- Phone-. �-I3_55_---- <br /> Ad6ness------------------------------------------------- _Stre-er_���_________________.___.____._______.____ <br /> Contractor's Name----------------------------- ���BONG»' INC�----''��-----'-�- ph�»» ' ------------------------- <br /> Installation will servo: RauidmnceXX Apartment House E] Commercial [] Trailer Court Ej Motel [] Other E] <br /> Number of living units: P Number of bedrooms L Number of 6ufhs]U Lot size----65A05«------_-.---_- <br /> Water Supply: Public system 0Q Communify system F-1 Private [:] <br /> Character of soil to m depth of feet: Sand [] E)mvn| L) Sandy Loam E] Clay Loom [] Clay E] A6o6e]U Hardpan El <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: | �� � <br /> (Nn septic tank or cesspool permitted Rpublic sewer is available within 200 feet.) <br /> �~~� <br /> ' <br /> Sop+icTonk: Distance from neun,,t *n||4o�� ounuon <br /> O O Brick <br /> Seepage Pit: Distance to nearest well__N_0X1_e--------Distance from founclafion-1V-----------Distance to n'earest lot line...101------- <br /> ------------------------- <br /> r' ` u/,po,o| F.o|u: Distance from nearest .e||_KPA!� Dlstonce from foundation 121 Distance to nearest lot line10 , <br /> Number of lines-- 1 0 <br /> Type of filter material--- -----Depth of filter material----1-8-H---------- <br /> I hereby certify that I have prepared this application and that the work will be done in accordance-wifk San Joaquin Coun <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> (Plot plans, e o; Pa�ion of system in relation to wells. buildings, etc., must be filed with'this application). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACC ------------------------------------------------- DATE ------------ <br /> REVIEWED <br /> _ ----_.----' .' -------------' -''��-m~' <br /> KB/|E <br /> BUILDING PERMIT ISSUED 4 ------------------------------------------ DATE�-.----.-.-.----�--._�_�_____ ' <br /> Alterationsand/or recommendations:----------------------------------------------- ---------------------------------:---------------------------------------------------------------------------- <br /> ----------------------- ____.__-------------_--.__--_-_._--_.____---_--___-._---.-_----'-_--_.-- <br /> _---_-''_-___.'''''--___''--'''''-'__---__+___-'-'--- -'''_---____.____------_-_ <br /> _.__-_-_._----------_-.-.__-___°�_----.-__--'__-�-�_----.___----..__-.----_---_-- <br /> -'_--'''__--_'�'''-__.__-._-._--_'-^�--------_-_._-------___--__--- ^ � <br /> PERM|TNo----- |35UE[\' -__(Dufo) FINAL INSPECTION BY: '_------------------- <br /> Date------------- <br /> 5AN JOAQU|NLOCAL HEALTH DISTRICT <br /> |30South American Street <br /> Stockton, California .' <br /> ES--9-2M p'so W-/639 � <br />