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` � \ <br /> ' ����T �� ��� �����T ��� �����7 <br /> ~ APPLICATION . <br /> ` p�mnmp�|ain �wo�cmfe 7' � Y � ~^ <br /> Duplicate) ~ <br /> Aplication is hereby <br /> / <br /> ^ <br /> e to the San Loral Hoa|H` District for a permit to construct and install the work herein described./hmuppioa+ion is made in comp|iancu'wMh County Ordina N o. 549 <br /> JOB ADDRESS AND LQCATI <br /> P-01 " - ---------------7------------------------------------------------------------------ <br /> Apartment House E] CoTmerciial� E] Trailer Court 1 0 Ot e El <br /> Installation will serve: '-Residence M�oote h <br /> ^ <br /> 'Character of soil to a depth of 3 feet: Sand [] Gravel.[] Sandy Loam E] Clay m E] Clay AJo6e)�r Hardpan <br /> T\�E �� LfW[|��N AND SPECIFICATIONS- <br /> 0 <br /> ^ <br /> ` tic tank or cesspool permitted if public sewer l, avmUab|ew�hin 200feet.)k. <br /> 6P,X! N D;s+uncp from nearest well-----------------Distance from foundation-------------------- <br /> `--_Material '-----.-.-------..---- <br /> �n. of ompo�mon+s---------_.Capudh/----_----_..Sizo-'--- '^ ------Liqu|d depth- <br /> ' _ - — -- <br /> ~ <br /> i |: D�� _ <br /> - � /m --- <br /> Size: - <br /> dv <br /> Privy: from nenr�tw�L'-_r-__-'__.-_.'---��+Distance from nearest building'-'''__'__.'_-_--_ } <br /> [] Dii+onm, to nearest lot line,--__-.__-_-__. <br /> Soo <br /> die I- <br /> Number of lines-----------I----------------------Length of each line---------8_,A_�---4_'__.Width of trench---- ------------------- <br />- ��� <br /> Type of filter maferial_,S_T_1-t1C-k----Depth of filter material-----181---------- <br /> A�e na o d ing and/or,rep irinq dqscriD --- ----------- ------- ----dew.t,_�......"_ <br /> --------------------------- <br /> ------------- <br /> Vhereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin-tounty <br /> ordinances, State laws,.and rules ancl regulations of the San Joaquin Local Health District. <br /> (Signed)A -,-f------- --- - --------------------------------------(Owner and/or Contractor) <br /> (Plot plans, showing size of lot, location of system in relation to wells, buildings, etc., must be filed with this application). <br /> FOR DEPARTMENT USE ONLY <br /> -------------------------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street <br /> ES-9-2M 9-50 W�1639 Stockton, California <br />