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APPLICATION FOR SANITATION PERMIT Permit No. <br /> � Ou��t� <br /> _ <br /> (Complete Duplicate) Date |ssuu6 ..!.����/��� <br /> Applica-l'ion is hnro6v made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This.application is made in compliance-with County Ordinance No. 549. 0--7- Do-2!�3 <br /> %�ADDRESS AND LOCATION---- <br /> " � � �Contrmctnr'x Name--- <br /> e4f3�f6 - � _---_--_----_.-_-_.-_------ Phone_-^«�r-~�.'--.\~-n~-.-. <br /> -___�...�-�.- <br /> |n�a|�t�n will serve: portnent House [] Commercial [] T,o||or Court [] Motel [-] C*6or [ <br /> � , o6nrvnm, �.-Num6o, of �u+hv 'w=.. Lot size . 2 �-.^Nom6er of |�iny -' ' -^- " m <br /> Water Supply. Public system E] Community system [] Private [] Depth to VVuhnr Table -------- ft <br /> Character of soil to m depth of fno+; Sand [] Gravel [] Sandy Loam D2- Clay Loam [] Clay [] /\6o6o R Hardpan [] <br /> Previous Application Made, Yo, F] No Z.- New Construction: Yoo & No [� <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public <br /> Sepfic Tank: Distance from nearest well.��0-1-----Distance from foun ion--.-A)--*------Maferi ---- <br /> D' I Field; Distance from nearest wefl- -.*55�.t-Distance �1-lm fouAdation /4'0�-------Distance to nearest lot line------ 4' <br /> Type of fiter material- A ep of filter material----- ......Total length---------------- <br /> 4Seepage Pit: Distance to nearesf well-------------------- Distance from foundation-*------------------Distance to nearest lot line---------------- <br /> I hereby ceyfify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> "laws, and rules I s of the San Joaquin Local Health District. <br /> a and regu;laf' <br /> ordinances, S!,af, <br /> (Signed)-,,,--6�1 "111;Z�XA,4—�---- -- - ------------------------------------------------------------------------(Owner and/or Contractor) <br /> (Plot plan. showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> --' <br /> ----- ---- --------------------------------------------------------------- ----- ------------------------------------------------- -------------------------------------------------------------------------------------- <br /> ----------------------------------------------------------- ---------------- ------------- ---------------------------------------------------------------------------- ---------------- ---------------------------------- <br /> / <br /> FINAL INSPECTION 8Y�� -_.-_----._' D*t�-,�.��..-�'�/7_-. v-`^----___._'___ <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> /nn s^"m *m*w"°" Street omoWest Oak Street oz Sycamore s+�°» mw North ^c;' Street <br /> St"=Ho". California Lod[ California Manteca, California nnc» California <br /> ES-9-2M x""/"°d wv'e/uo <br />