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_---' _ -- <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br /> (Complete in Duplicate) Date Issued __1Application is � <br /> hereby madefo`fhe San Joaquin Local Health District for a permit to <br /> ^ <br /> This application is made in compliance with County Ordinance No. 549. <br /> JOB ADDRESS AND LOCATION <br /> Contractor's Name, <br /> Installation will serve: Residence 'ApIrtment,House El Commercial E] Trailer Court E] Motel E] Other El <br /> Number of living u Number of bedrooms .-or-Number of baths --- Lot size, -------- ------------ <br /> Water Supply: Public system..t,.7c 0m, munity system El Private [:]. Depth to Water Table I& <br /> Character of soil to a depAlof f"t:j Sand <br /> � -- Gravel -- Sandy Loam -_ Clay Loam -- Clay' Adobe_ Hardpan E <br /> Previous Application �ade: Yes No New Construction: Yes O� No'�V FHA/VA; Yes N <br /> TYPE OF INSTALLAfI- AND _ -_ -. .._.-'No. of <br /> (No septic tank or'cesspool permitted if public sewer is available within 200 feet.) L <br /> Septic Tank- Distance from nearest well-d"eDisfance frojp foundation-AW. -----------Materiai___ 'e�rcl -------------------- <br /> --- ' --'-r-' <br /> Dis al Field: Distance from n.a s, <br /> we <br /> -.D;stance from �ounclation_,?�_,---------Distance to nearest lot line.---,S---------- <br /> Ty' e of f0ter mafe'ri*al---"2.07,f------Depfh of filter material....Zf-----------Total length--------__!T <br /> Se e Pit: _'Disfa' n'�Wfo` nearest y/ell--- :,iT--.-�Dis'-tanc'e-'fzoqi"foD d�fion_!7!0---------Dista'n <br /> --------------------------------------------------------------------- <br /> ' u <br /> District.- <br /> (Signed)I here6y.cerfify-that I have pre!�ared this ap Ii i -d hat the work will be done in accordance with San joaq'uin County <br /> ordinances. State laws', and rules and <br /> -- V e. ` <br /> (Plot-plan, showing size' of lot, locatio�n of system in,relation to wI uIldings, efc., can b� placed an reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED ur ' <br /> RBUEw/ED 8Y-''' | <br /> --------------------- <br /> BUILDING PERMIT ISSUED <br /> |SSUED--__ _-_--- � .. ^� � '__--.� <br /> ' E- ` --____ <br /> . _ i_ - sk .�_ ______------ <br /> _ <br /> A�e,a�nnsmnJ/wrreo�mmen6ahon�- _-..__ _ -__-. �__--.-___ -_-- -_- <br /> '-'---'--''-'--__''-'.�--'-''--'''--'` ` . ^ ^ <br /> '''-''''---'''--__'_-''--_---`-''''--''----'''_--_.--____'_ <br /> __---.----_-�_-._-_-.-�--..`---._-_---._.- _ --_----_-__------..------_--_--__'' <br /> ___________---_--------.____ ----___--- ------------------------------ ---------------------------------------------------------f- <br /> �l <br /> ' <br /> ----------------------------------------- --- --------------------- ---------------------------------------- -------------.-'.`'------._-_----��--�-��-------_-.. <br /> / � . . . . . <br /> FINAL |NSPEC TION BY ' - �Dmfo' -''--------''__-'_____ <br /> � <br /> SAN J0vAQUDNLOCAL HEALTH DISTRICT <br /> /m south America" Street 300 West Oak Street /32 Sycamore Street nw North "C' Street <br /> Stockton, California Lodi, California Manteca, California Tracy, C^|lif"m|w <br /> ES-9-2M n°"isov 1.57 r,n�oz � <br /> ^ <br />