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rpROFFICE USE: <br /> ~' <br /> APPLICATION FOR SANITATION PERMIT <br /> N� -l��L� <br /> - " � � �� <br /> ° =,= � r�="p~e'~ �°p��'~r 8ah* �*uwd _ �' . <br /> Annic�tionis hereby made to the San Joaquin Local Health District for permit toconstruct and 'install the work herein described. ' <br /> This 0 U f|o is din compliancewith County O �i No. 549 _ <br /> JOB ADDRESS AND, <br /> ^^°"�,, "�",� . .. -. �/_��_ <br /> - P6one__ � <br /> Contractor's Name.--- ..- --^--------_-----_.----------.-_.. --_.----_---- <br /> Installation will serve: Residence Q3,'Aportmmnt House [] Commercial [] Trailer Court [I Motel [] Other [] ^ <br /> ^Number o{ ||ving units: ' ^�- Number of6edrooms5- Nvm6a, of baths ^/-' Lot size Ple',-_-''.-..-----' <br /> ��' �p'� �6|� �� � �mmun� ��m � � �� � `��, ��w�� 4 4 <br /> '~' -- � | <br /> Character of soil tom6�� � � �� �� [] ��� � ��� L�m � �� L�m � �� � ��mgeHu��n � <br /> --,- . � <br /> Previou"s Application Made: Ufyoo,�o�-----'�-) No k2,`0*New Construction: Yes [] FHA/VA. Ye* Z�~-No [] ! <br /> TYPE �F AND SPECIFICATIONS: <br /> (Nm septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic. |��� <br /> Tank: Distance hn ,os --- umo »��^ <br /> No. of compartm ;4/ <br /> Disposal Field: Distance from nearest well------—-------Distance from founclation,_h?p----;....Distance to nearest lot <br /> Number of lines......Z------- Length of each .......Width of trench---Al <br /> ---------------- <br /> - 6�� ��' ' to | �� ' <br />. Type of filter material. 'aDepth of filter material--- -------Total length---� i <br /> R+: Distance to | D�� ny� <br /> Number of pits-----m?------ ------Lining motvrmi�&."A__-Size- u/mmeter`1-x- -------ueprn°�°*x-_'-_-_ <br />, : Distance from nearest well ''_-'.-Distance from foundation ' ---------------Lining muteriaL'-'_-'--''--_-- <br />" 0 Size: Diameter -.___-_ ----------Depth------------- --------------------------------------Liquid Cmpucit^._----__-'gois <br /> Privy- Distance from nearest well---_--___----..D�fonce from oaoro, building------------------------------------------ <br />` [] C��onoytonouro, lot line __ -_-'-__''--'--'_-'--''-'---'- � <br /> ~ <br />� ' ng and/or repairing (describe) -----------------------------------­­ <br />/ _______.____________.________________�_'_-'-_.'- c''--- ------------------------'------------------------------------------------- -= <br /> --.-�----._----------_-_-_-------_.-------_-_--------_--_---_.-.-_-.______._-_----- <br /> --------;!-------------------------------- -------------------------------------------------------------------- ... -------------------------- ------------------------------------------------------------------ ----------- <br /> I hereby certify that I have prepared this application and that work will 6e accordance with San Joaquin County <br /> ordinances, State laws, a4rules and regulations of the San Joaquin Local Health District. <br />^� . <br /> � <br /> \mg�wp/_ v��^r�u �m°*���=` ' <br />� -------------- <br /> ~r <br /> ells, buildings, etc., can be placed on reverse side). <br /> ' <br /> F9R EflARTMr USE ONLY ~ <br /> /�PPU���0m *c��p|�o ur - <br /> BUILDING PERMIT ISSUED--------- --- ---- ------- ---- ---WZ- <br /> Alterations and/or recommendations:. <br /> '------------------------------------------' ------------------------------------------------------------------------------------------------------------------------------------------' —'--- <br /> -----'-'' ''_'--'---_ ---------------------------------------__.-'----'-'--'--'''-''__.''-'-''-'- - -.- <br /> --',-'---- _ -'''-''_-_----- <br /> - <br /> ----'-- <br /> ' <br /> . HN/ L |NSPECT|{ N <br /> D=+=- ^ <br /> h------.-.- <br /> SAN <br /> J AQ UIN L CAL HEALTH^ DISTRICT <br /> 130 s""m Am°,/=,"w*ew xww w°m Oak Syreet 12*Sycamore Street uos West 9th.Street <br /> ' m""um"'California L*w/,California Manteca,California Tracy,California <br /> cs y ncvsso 8'59 zu o'an xrLxm <br /> � ' . <br />