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~~ <br /> APPLICATION FOR SANITATION PERMIT <br /> (Complete in Duplicate) <br /> construct and in��U the <br /> herein described.wu� <br /> Application is hereby made to the San Joaquin Local Health District for u permit to con <br /> This application is mn6� |n comp|iuncn with County Ordinance No. 549. <br /> --------------------------------------- <br /> JOB <br /> ----_--_---.-.-- <br /> JUB ADDRESS AND LOCATION <br /> --.----q�'�/..^.�'��~ .�,--�---'--------.-_-_B. _.�._kr_._.i-__Phone <br /> ._--_--_._---___-_--_-'-_-_-- <br /> --_-' <br /> '_^ <br /> Owno,'s Name-----------4- <br /> Address- <br /> A6d,eo. ' ___'_'____.___________�____________�__ <br /> Contr*ctor'o Name` - -''-'''—'-----------'— Phone <br /> on oo,vo: K�,�6�nc* �� / Pu�m«»� House xCommuncia| [ ''-i|v, Court E] Mote [ Other E] <br /> |n�aUmG - <br /> - <br /> _ <br /> .-' �� .. �.�'�-�� <br /> ---' <br /> Numbor of living units'. Number of 6n6nuoms [j Number of 6o+h" Lot size <br />' Water Supply: Publicsystem4C»mmuni+y system El Private El <br />) an El ~Character ` soil to a depth of � fna+� 3un6 [] �rnv�| �� Sandy Loam � Clay Loam LJ Clay �� ��.�~ � H�� p <br />� <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> `Nn septic tank or cesspool permitted if public sewer isavailable within 200 feet.) . , <br /> 6upti�cTnnk: Distance from nearest wnU------.-Distance fromfnmndation---':---- uf°r|o|' . <br /> , <br /> ! ~ ` <br /> FNo. v��ompmrtnont�__-.--'-_._Cupu�+�_.----_-`-»zn----.-____._�q_d I depth-____.__- <br /> Ceucoo: ` efrom noureo waL'___.-D�+oncefrom foundo�vn_-'-_-'_U Lining mv+uha\-' ' --''-''__.�- � <br /> Dista <br /> S�;� O|u�e+er_---._--_--_Depth._---_-_---_---__--Privy: Distance \ <br /> i �� Distance from nearest building -'---------'— | <br /> fm�� nearest well --' <br /> ion ------3 D t �0 <br /> Seepa e Pit, Distance to nearest well----------------------Distance from founciat 4ance o ne. IF <br /> Number of pits-- -----I-----------Lining materiaL-3-1R-;4Aj<--Size: Diameter- oe <br /> 20 <br /> sppsa I�Fi el d: Distance.from nearest well------A!7-----Distance.from founclafio <br /> Type of filter maferial--j- -R-eh4-kDepth o� filter rnaferal-------- -------- <br /> ----------------------------------- <br /> I hereby certify that I have prepared this application and that the work will be done in accordance with San-Joaquin County <br /> *1 cl gulati6ns of the San Joaquin Local Health District. <br /> ordinances, State.-laws.4nd r 61 an ,re ----lOwner and/or Contractorl <br /> (Signed)---------�-2- ---------- ---- --- <br /> (Plot plans, showing size of iot, location of system in relation to wells, buildings, etc., must be filed with this application). <br /> U NL" 1110 <br /> .. .... ..... .. ..... -------T-� <br /> ------------ <br /> APPLICATION ACCEPTED BY-------------------- --- ----- ------------- nDiA, T E------------------ ------------------------------------ <br /> --------------------------------------------------------- <br /> PER� r-3------- ISSUED -------- <br /> ��7 ?/P ----------------------------- -------- <br /> ' SAN J{]AQU|N LOCAL HEALTH DISTRICT / <br /> ' \80South American Street <br /> Stockton. California <br />