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APPLICATONFOR SXMTATION PERMIT ^ <br /> ' 16 , <br /> . ^ . . . <br /> Application kare6v made to the Sun Joaquin Local Health District for ponn� +000n��dand ��u the work �� described. <br /> This application iswithmade in compliance � � County Ordinance No. 549. <br /> B ADDRESS AND LOCATION--------- 41 �� - <br /> ----------------------------------------------- <br /> - - <br /> Installationwill serve: Ruii6�nce ��'� <br /> | ��orne�t House C~�meci6h� Trailer Court <br /> [] Motel [ 'Other <br /> ^ <br /> Number of living units: [Z Nu-mbef=bf*6vd,opm, Number. n �] <br /> �.��`�4/r,0-0-_.--_.------'_ <br /> | ' <br /> � system <br /> �� ofer Supply: Public ' ~ � Private �j <br /> ��� � � � m �-,. � 3 .~~.` �� � Gravel E] Sandy Loam ( Clay F] - Hardpan � <br /> . ` . <br /> TYPE OF INSTALLATION AND SPEt|HtATk]NS, ` ~� <br /> (No septic rmnx or cesspool p='"""=" if public sewer is available` within.�- -- --` <br /> | <br /> Septic |unk' Distance from nen,o, well-- Distance "=�kU^~'r^- <br /> / compartments _r��-� ~`- --------.Liquid 6eot ~ � <br /> \ F-1 Size: ".a..".~. -------------------Depth ---------------- <br /> ` '' <br /> ' SePit: Distance <br /> Disposal Field: Distanc6 from-,n6aresi�Vell__��___.Disfance from founclafionlq------------Distance,to nearest lot line--- <br /> Tvpo vf �|+o, ^ � L <br /> � -����_-__.Den+ of filter motnrioL�-&�_._' <br /> --�-'-----------~------~--''--''---'---'-i�~--��-�'�-�' be--'6 - - '����rdan�mw�hSanJpa�u� County <br /> I hereby certify h �cm+�n and a+ fhm .mwm will <br /> ordinances, )Sfa e laws, and,rules and regulations of the San Joaquin'Lo'c'al Health District. <br /> (Signe ,Z (Owner and/or Contractor) <br /> By ` ---~ ' ~ <br /> (Plot plans, showing size of lot, location of.system in relation fo�wells, buildings, efc., must be filed with this application). <br /> ' FOR EN <br /> � Alterm+|onoun6/o, recommendations:------------------ ----------------------------------------------------------------------------------------------------------------------------------------- <br /> | --------'--''-`'-�---'--_=---'—'-----------^-------'---------- ----------�' <br /> ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------'-------------------- <br /> .__------------------------------------------------- ---------- ------------------------------------------------------------------------------------------------------------------------------------------------- ------- <br /> . -------------------- <br /> [ PERk4[T No *���. '- ISSUED------ ---------(Date) �N�L |N3P��|u�m-nr �� -____ <br /> � ' Dv+�.-.__.�._-L� -.'-..-�.�..�-�-+�_____. <br /> SAN JOAQU|N LOCAL HEALTH mu/RvC/ <br /> 130 South American Street <br /> Stockton, California <br /> 9-an wc/um <br />