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1 _� � P�m� <br /> q7 <br /> APPLICATION FOR SANITATION PERMIy/ � 7 Nu <br /> in Duplicate) <br /> Date |smus6Applic-64-ion is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein.. <br /> described. <br /> This ai'pplication is made in compliance with.County Ordinaric N o. 549. <br /> OB ADDRESS AND LOCA A - -- ---------- ------ - - ------ --- - ----- ----- -AV <br /> --------------------------------------------- <br /> |nstu\lationwilloanm: Residence [� /\purhne Commercial [] Trailer Court [] K4o+o 0 Other LJ <br /> _- . � <br /> Number of living units: ��'-�vm6orof6�6room� -."3-� Num6u, of��o+h� .��- Lof ,�o -_�-.-.__'__---___ <br /> Water Supply. Public itv [jPrivate E] Depth to Water Table-3-s�,- ft. � <br /> Character of soil to a depth of 3 feet: Sand 14 Gravel E] Sand Loam El Clay Loam [I Clay E] Aclob<_Hardpan E] <br /> Previous Application Made: Yes El No Ej <br /> '�ew Construction <br /> TYPE OF INSTALLATION AND _,__FICAtONS: <br /> . . <br /> No septic tank or cesspool p;rmifted if public sewer is available within 200 feet.) <br /> Ma <br /> . ---- <br /> Septic Tank: u. wn/^;scx-°l."°.= ce , <br /> °-� <br /> �� � + ne� w°/ <br /> Disposal <br /> '`""'b= of ^'~^' ~~' <br /> rial <br /> ' <br /> . A49filter, t�n Distance �a�_�'��t`kn�� -------------- <br /> Seepage ^ <br /> p�; D�t »cet» n«a�� pK -----'Distance from /""n6u <br /> ------------ <br /> Number of . '-,''---Lining moter�aL� --------------- Size: Diameter-------------- --------Dw�+n_ _'_----_ <br /> C�,spop|: Distance,from nearest well----------------- from fnundu�on-----.-L��g muf&�-------------------------------------- <br /> - <br /> El <br /> Size: Diameter --''-''' ------: -------D n+ � Liquid Capacity-------------------------- oa- <br /> ` ~ `Privy: Disfance romnearesfrom nast building' <br /> 11 <br /> ._-.__---_-__-._-_--__--_----._---_------.__-_-.___.-_.-._-_-------~�-_-__-. <br /> � -^''---___---._-__ F_- <br /> --.--._._-.___.__'-___.__.-._�'--���''-''-'^---'_---''-'�----'- <br /> ' ---- ''--'------'---'''-----'--'--''---''--''-'--'-'---''---''----'-- <br /> ---'-------'------' preparedI hereby certify that I have this application and that the worwill be done in accordance with San Joaquin CwunfYordinances, State laws, and rules an r gulations of the San Joaquin Local Health District. <br /> ~� -' <br /> ' <br /> ol <br /> (Plot plan, showin size of t, location of syste in relation to wells, buildings, etc.. can be placed an reverse <br /> FOR DEPARTMENT U-SE ONLY <br /> .- <br /> "E.E,.E° BY -'--- <br /> � <br /> Alterations and/or recommendations.^ --------- <br /> �^ .x�°�+�� -^� --�������--------'---'—'' <br /> °='-'-~�-~~- ,�---_�________-___�________________________ -------------------------------- <br /> ------------------- <br /> -._-- ^ <br /> .-''--''-'''---' -'-'''---'''_-------------------INSPECTION <br /> __� ____ _____ __�� <br /> ' <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> wu South American Street 300 West Oak Street |nu Sycamore Street 814 North "C" Street <br /> $" l+"". o°|/;"mia Lodi, California Manteca, California Tracy, California ` <br /> � <br /> ""_" ~"°"^`°"�" <br />