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zz�_ / <br /> AP~ . L.~ .._' ' . _' SANITATION- ..- -'- PERMIT <br /> - ' <br /> (Complete in Duplicate) Date Issued <br /> ' ( <br /> ~ ' <br /> ` mu6o fn ��eJoaquin Local Health Dist for� o permit to construct � � <br /> and �no||+6mwoherein described. ~ <br /> �'A� <br /> Tplication is hereby <br /> � opcJicution is made in compliance with County Ordinance No. 549. <br /> JOB. ADDRESS AND LOCATION------------7 7-1_�/-------- --------- - ----------0----I----4-----t-4- -;-4�__j <br /> ""d'e" --------------------------------------------------- <br /> ----------- ------------------------------------------_ ----------------------------------------- <br /> Contmc+or'o Name'_-___--'.����*t$��i--' -------------------------- ----------------- Phone-__________.. <br /> |nstallation will serve: Kesi6ence � Apartment House ElCommercial E] Trailer Court [] MotelE] Other <br /> Number ofliving units: --- --Number ofbedrooms Z~ Number 6fbaths~�..��Lnto�o ------ . °r-e.�---' <br /> Water Supply: Public system El Community system El Private Depth to Water Table -------- ft. ' <br /> Character of soil to a depth of 3 fee+: Sand [] Gravel E] Sandy Loam [-] Clay Loam . { lay [] Adobe Hardpan F] <br /> J <br /> Previous Apr--� Made: Yes'[] No New Construction: Yes [Z No El <br /> ~-° <br />. TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet <br /> Septic Tank: Distance from nearest well-_�' -----Distance from foundation/ ------ ------------------------ <br /> e " � <br />� w,p�`�. Field: "'"'""`" "=' ^"�'`~' ~~'' -^~ ~'~~^'`~ ''~^ '`~^`~^~ nearest— — lin-- <br /> Type of od filtermotorioL Depth of filter material'',�9---------Total length---------/~4-_10-------.-'' <br />� Seepoge Pit: Distance to nearest well----------------------Distance from foundation------------ --Didunce to nearest lot line <br /> i |�m�.--._.. <br /> Num6er :fp .[ '—��''.-��ing ��. <br /> mofnr|ui-'�'-'''—�Sze� Diomvt�,--'''-'�����Deo+�—_''--'`,-�- <br /> Ce . <br /> Cesspool: ��t noefn�mn�nn»� �oL''----D�toncefnzm �ouv�����'--._=�U�ngmoto,nL''''-'-��' ------'- <br /> [J Size: Diameter.----_~r.-_---Depth----------------------------------------------------Liquid Capacity----------------------------gals. <br /> / Privy: Disf nc" fnzm <br /> noon,st *e|L',---''_------'_.�D�tancv from nearestbuilding�-_'------------------------- <br /> El <br /> --'''--~ -- <br /> E] Distance to nearest lot line'''---'''-�'''-'��_' � ��'��'____—�_'''� ��''''-' _'-�'_- <br /> '� z <br /> Remo6e|imJ '- <br /> � <br /> and/or repairing (6ouzi���''_''''—''''_���-�__.---_.-''__'---'��_--___''____.'--_________ <br /> -_---..--.__----._---__-.-----___._----_-_-_---._____..--_----------.----_---_ --. <br /> � <br /> -----___-----___-----_--____-_._-___.-_ .__._--_____.-._-'--._.__-_.—..�-~,-- <br /> � .--.-_._-_.—:--_.___...__--___.--_-..._�---�__'..__-__'-__.--_.-'------------------------------------------------ <br /> '--. <br /> I hereby certify that Lhave prepared this application and that the work will be done in accordancewith San Joaquin Countyordinances, State laws, arid rules and regulations of the San Joaquin Local Health District. <br /> ^ <br /> � =�=`�-�-=.^~�"�..~~-.��-.~.�-_----_-_---__--.. -. `_—_ and/or_ __._--' . <br /> ' <br /> By:------------------------------------------___''------------------------------------------------------------------ -�—'---'—� <br /> (Plot plan, showing size,�of lot, location of system in relation to wells, 6uU6im 'beplaced on reverse side). <br /> 1�0 ENT USE ONLY <br /> ~ �� ACCEPTED BY <br /> =�° ` <br /> BUILDINGtf_ <br /> � <br /> ions and/or vicop3ndSAN JOAQ0N LOCAL HEALTH DISTRICT <br /> 130 South American Street 300West Oak Street m: Sycamore Street ow ^o�th 'cStreet <br /> Stockton, California Lodi, California t4infeca, California Tw"v California <br /> - <br /> ES-9-2M /0-52 n".is"J vv-2/00 � <br />