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` . <br /> ~ � <br /> ` <br /> APPLICATION FOR SANITATION PERMIT PennitNo. <br /> - <br /> yy) k�mmo�� � Oupk�f� <br /> \�^ (Complete On+� Issued <br /> ~^ - <br /> Application is hereby 6o to the Sm Joaquin Local �eAth District for a permit to construct and install the work herein described. <br /> This application is made in compliance with Count 0 j na�nce 549 <br /> -------------------------- <br /> Owner's Nam <br /> Installation will serve: Residence Apartment House El '-Commercial F]. Trailer Court E] Motel El Other n <br /> Number of living units- 16�dmom� .�L�Nuh`6o, of baths -]�- Lot ,bo ��0� <br /> . -_------------.-..---- <br /> Water Supply: Public system Community r�stem Ej Private F] Depth to Water Table !�q ff. <br /> Character of soil to a depth of feet: S � ".Gravel [] Sandy Loam [� C| Clay [] ,�J mrdpan E] <br /> Previous Made: Yo, E] No �`� NrwC'n�'ruc+ion:'Yes [j No --�' FHA/VA. Yes No --y' <br /> TYPE OF |NSTALLAT|O- ^AND SPECIFICATIONS: )�` ' -- <br /> (No s-ttic"faink"or'cw;;pow| permitted if public sewer is available within 200 fmw+.) _~ <br /> Distance from nearest .eU-----------------Distance from foundation--------------------MotoriuL-------_`-------- <br /> - No. ofcompo,fmenfs---- Size-- ------------------------..Liquid 6epfh--------------------------Capacity------- <br /> "'sp"s,' . ."." m,nwn"o from nearest O.-NN41DIstance from foundation---10............Distance to nearest lot line______1Sj_17'/ <br /> Number of lines.' Length of each line------�3c .1 Width of trench----- <br /> � '� � <br /> .~..... ~ p", ^ � "* "m.enm/ \� <br /> ' Distance--- from --c-` —''-'---'--~'''~'`~^~^ '~~'~~'~'—''���--Lining material—''-'-_________ <br /> 171 Size: Diameter.'�.-��'-'''- --'—Deot�.--''''-''''_'''-_-'--Uquid Co . ----------------------------gals. <br /> Privy: D��anc° from n�amo+ weU----.--.--------'D��n ` fn,m.nounos+ building--_._.—__�__'- w <br /> [� Distance to nvor�� lot |in����� - ' - � - ---' <br /> � -'''--'''�-''-----'-- --'''---'---''''-'-'�-'--''-' u� <br /> _�, <br /> ^ Komod��g and/or repairing �o, �6m)� . ' �*/ <br /> . . ' —� ''''-''-_-'- --'-__-''----'--__. <br /> - ' . <br /> '--'_�_._--_.'__.-_'-�- --+_-_-__'''---'--_---'-'-'---_.'_-.-'''-''�`---' <br /> ^-_--.�_---_-'---_-'-''_-�'--.��_�-�`_�'-�� -_-..__'.__.-�_.-_-� � ` <br /> --'-'---''-'''-----''----'._'''�_..____--_-______'-_-�__--_.---._ ._-.-_---------- <br />� | ^ ��� ----- ' ` <br /> arecl this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws. and rules and regulations of the San Joaquin Local Health District. <br /> (Sig <br /> ~ -_-'''-��'---''---'''''-_.'''--'''---`..~-- <br /> ' plan,— sh6-n~ -kze of��-� —' location of system— in relation to wells, buildings, ~'~7 can "= placed wnreverse sid*f <br /> FOR DEPARTMENT USE ONLY <br /> ------------------------------- <br /> ------------------------------ <br /> / <br /> / . <br /> __. �=" ^ �=�� .-- - <br /> --___-�-� ------------------ <br /> '�= —. ----�/��~.�'_ ---------- <br /> --------------------------- <br /> _-. . <br /> '-------r-' ' -----'-----------------�--------''-'-'-'_------------------ <br /> FINAL <br /> _______ <br /> . , <br /> Rm/\L INSPECTION 8Y cA \o�,�� <br /> ' �n�/=� � �' <br /> . .... _ ~. ___.- .________________ u --',���4�-�-'''-'-'--'-''----'— <br /> ' <br /> ' . SAN JOAQ0N LOCAL HEALTH DISTRICT <br /> 130 South American street 300 West Oak Street /32 Sycamore Sfreef m^ North 'C" Street <br /> Stockton, California Lodi, California Manteca, California Tm*v California � <br />