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' APPLICATION FOR SANITATION PERMIT Permit No. -��'�� «' r (Complete in Duplicate) Du+m Issued -'/�//��' 7- �� ct Ann||ou�on is hereby made to the San Joaquin Local Health Dkt,ictfor u permit +ocon construct and im�aUthe work 6on�n6esr�od. This ' application is made in compliance with County Ordinance No. 549. mmercial [] Trailer Court 0 Motel [] Other El Installation will serve: Residence Apartment House El Co s -1---- Lot size --- 01 14-----/-.;, f Number of living units: Number of bedrooms _1k--- Number of bath --------- - --------- Water Supply: Public system 5r,"Communify system El Private n Depth to Wafer Table -------- ft. Character of soil to a depth of 3 feet: Sand E] Gravel E] Sandy Loam 171 Clay Loam F] Clay 0 Adobe k0"Hardpan E] Previous Application Made: Yes F No El New Construction.- TYPEOF |NSTALLAT|ONANDSPEC\F(CAJ|[)NS: (No septic tank o, ce`apnw| permitted if public sewer |savailable within 200 feet.) Distance from nourn�+ well----------------- from foundation-------------------- c No. ofcompartments--------------------------S|zuLiquid clopfh ..Cupacity ' -----..�-. lot �^^" .� ." "��."=. e^/- Distance from nearest well A-049— +,�m foundation Distance1.4 � � ---------- Number of lines--- Lengthof each line---- '�-�- ---- .ori�| ---- Typeo� 8|t*r mof � �/ DrF^' of �|te, mo+nroR � + l length--- S t6 `^ ~` Distance to nearest welL--_--'_Distano, from foundation------------ fo nearest lot line nx ~ Number p��'''''-''''�ning mutv��--_'''''-'5�e: Diameter -'_----'Dept 6_'-'��-'-'-'- ~` '--� Distance from nearest well-----------------Distance from foundation --__--Lining material . . F1 Size: Diameter-_----------------Depth- . Liquid Capacity -.gam. � Privy: Distance from nearest well------------------------- ---------------------- Distance from nearest building------------------------------------------ � �� Distato ,+ |o+ line -__ ___-- ___ Remodeling and'/of repairing (describe):---*-------q, Az Z &--------------- .__ __y I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances,5itaile laws, and rules and regulations of the San Joaquin Local Health District. ----SVC----------------- By--------------- --------_----------------------------------------------------------4-- ----- A :i ing tc., can be placed on reverse side). (Plot plan, showing size of lot, location of system in relation wills. . .. ....... FOR DEPARTMENT USE ONLY Alterations and/or "ecommondmions:----------------------------------------------------------------------------------------------------- -------------------------------------------------------- —'—'-------`-------------'-------'-----'-------------'-----'------''---- ------------'-'''-''-'------'''---''''--''-'''--''--''''''----------------- ---------------------------------------------- ----------- --------------- ''' ---------------------------------------------- --------------------------'--------------------------------------------------------------------------------------------------------------------------------------------------- -'--.----'-''''-' - -''----'--_-''-''''-- ''''-''-'�'-'---''---- �� FINAL INSPECTION BY:------------ -__----. "a."- .._~�~.~.________._.___ _. SAN JOAQU|NLOCAL HEALTH DISTRICT ^ /oo South Am°a"o" str"m 300 West Oak s*=°* mz Sycamore Street m* North "C' Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2 Ki . n".i"°v 1'57 p.p.cp.