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` APPLICATION FOR SANITATION PERMIT Permit No <br /> \ A���m�+a |n Du��a|e <br /> (Complete . ' / Date Issued <br /> ` <br /> Application is hereby made to the San Joaquin Local t ct for a permit to construct and install the work herein described. <br /> ct <br /> This application made �mm / <br /> JOB ADDRESS AN ' <br /> ! <br /> ^ Commercial Trailer-Court Ej Motel [] Other [l <br /> Number of <br /> � living bedrooms -` � ` <br /> . VVa�v Supply: Public system ElCommu�ty system 0P,Private ~~ <br /> �t� U�� ueo+ Water uh,rTo6|o -------- ft <br /> Character of omU to m depth of feet: 3d Gravel �] 6un� Lo Clay Loam [� C|�y'�� �� � v6pon [] <br /> Previous ApplicationMade; Yes [] No � New Cnnstruct/on: -Eis <br /> -`~' u El ^HA/VA. Yea E] No/TYPE OF INSTALLATIONAND SPECIFICATIONS: <br /> /No septic tank | permitted if public sewer is availableV�/rnm 200 feet.) <br /> STunk: Dis+vncd from nearest u fn n ,. <br /> 9* " ^ <br /> No. ofC'ump^rtmenf,-. 2�, —`-.--.. ��r��^��.� Liquid d pm �� �. ry f� <br /> i D R*�� D|�u fnzm nearest | from ^�� ^ ^�!- <br /> ' Number of <br /> |inLength of each xm�._. � ---------------~�m o. french <br /> --Depth of �Hor material_____/_e |ano+ -_'- <br /> � ------------------- <br /> Type <br /> of ��vr mufo��_ <br /> ' <br /> Seepage Rt: ' Disfanco:t'o nearest well '-_'-'-Distance from foundation-_--___-Distance to nearest'lot |in�-'''_-- <br /> [] Number "fp�s-----.—Un|ngmafo�oL_------S�e: Diomotec.�_------Depth--------------------------- -- <br /> Ce0000l: Dist nuo,fn,m nearest well----------------- �-''''''-Un�gmotor�| <br /> Size: �nm*ta,------'--_' -�. � - --------U�ud Capacity---------..gab. <br /> r\)� <br /> u�.~ - ^..,-`-`,-'-�-_ <br /> Privy: � <br /> Distance nearest ��U-------------.—��D|d���e from ne�n,�6ui|�inq-^-.`-..._.�.-----� � <br /> F1 Dist6cet" nearest lot line_----------------'''�� ------ _--_�_._______________�__��__________ - <br /> | ' Komv6el|ng and/or repairing (Jbscriba):------------------------------------------------------------------------------------------------- ----------------------------------------------------- <br /> '- ` <br /> � __.-__-__------._-�-..~`----__..__._-__-_-__'----_--'_._-_.-_-__----'--._--'--_�---. <br /> . '__.'-_--'_-'-_-'-_--__�''-_-'''__.---'-'--''--''_. <br /> ----------------------------------------------------------- -------------- <br /> .------.___..__---__-_-...__--------__',--_'-----'-'--.--_'^_''-___-''-_.'-___-'-''—'''�-'-' <br /> I hereby certify that I have prepared this application and that the wu, °0 be done in accordance with San Joaquin County <br /> ordinances, State laws and rules and regulations of the San Joaquin Local Health District. <br /> / 6 <br /> � .. ��-.'Owooran6/o, Con*uc*n�»� < nm6i. 4^-.[ ^ � ,------�---'-----------'------' <br /> ' _____.______ ------------. �_______-______.________.__----..D�koL_------'---------'----' <br /> (P�t plan, showing size of |mt. \ocat�6of <br /> T` <br /> system �n "n|a��n +o wmU». buildings, w��. can be p|moo6 on reverse �6*). <br /> FOR u=,"R.','^'`' USE ONLY <br /> APPLICATIONACCEPTED BY ----------------- ---------------------------------------- DATE-------------------------- -------___.. <br /> REVIEWEDBY---------------------------------- - - ------- - ------ ------------------------------I-------------I-------------- DATE-------------------------�-.q-------------------------- <br /> ^' BU|LD|NG pExM|| |S»uEu_' __4J 1, .11� <br /> FIN/\L INSPECTION BY:--------_-_-----.--.—.. Date--------------------------------- -------------------------------------- <br /> SAN JOAQUIN <br /> -------------.SANJOAQU0N LOCAL HEALTH DISTRICT <br /> 130 South America, Street 300 West Oak Street /32 Sycamore street ow worth 'C" Street <br /> Stockton, California Lodi. California Manteca, California Tmxv California <br /> ss-9-2w u=u°6 1'57pp.c0. <br />