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. . <br /> �*^ <br /> APPLICATION FOR SANITATION PERMIT <br /> ~�- �p Permit No. <br /> - <br /> (Complete �n -~r'^~'=v/ � ' <br /> Date /mmod --- <br /> Application <br /> Am|ication is hereby made to the San Joaquin Local Health <br /> This application is made in compliance with County 0 District for <br /> a permit to construct and install the work herein described. <br /> CATIO <br /> Aance No. 549. <br /> JOB ADDRESS Al� <br /> o <br /> ^ ------- <br /> Contractor's N <br /> , Installation will- serve: ._......" "pvnmrm HCommercial [j Trailer Court 13 �40�el El Other E] <br />� Numberof living. units: ^. Number mnbedrooms - N 6e / Lot size <br /> Water Supply: Public system 2/community —'- <br /> Character of sail to-a depth of 3 feet': S d I Gravel [] Sand L <br /> Previous Application Made. Yes El A. 0 ;�O _y oam 1Z Clay Loam 0 Clay El Adobe RZHardpan E] <br /> N New Construction: Yes <br />� TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> -- No <br /> compartments(No septic tank or cesspool Permitted if publicisewer is available within 200 feet.) <br /> No. of <br /> --' t. Size ��_X __;� ' - id d h 4/_�4 <br /> -- <br /> DDistance to nearest lot line Z5 <br /> o�. Distance from neares� welltu+ ------Liqui Ep -------- --------------- ap <br /> - Distance from ---- <br /> lin <br /> " - -'� ~Number �� - ' ----- 7 `'""' «rnoncn- <br /> -'~'-'Typo of filter mafn..� ~ '-� Aep+ of filter mafo�aL-'�' ---�u�| length------- <br /> Seepage Pit: Distance to nearest weL---�'''-Didance from foundation �'--�--D�+um»u fnneun:� |�t-�line <br /> Number phs--___ Lining majar�L' --'--�zo: Diameter----------------------- <br /> Cesspool: D��no, from neo,p,f woU-----D��nnce from foundation �'----�ning material--------'LSize: D�mn+er_'._'--------------------------------------Depth -------------- ----------- Capacity_'Distance from n*oros� well------ ___.__�''-- <br /> -_'_--'�_---_-_'-_—g--_o_--� <br /> ___—___--'-----D�t nca '-. <br /> - <br /> & <br /> from neonz� �u��ng------------------------------------------ <br /> � El u/�anoefonearest lot |�° � - <br /> _ <br /> Remodeling and/or repmr�g |6osc�b : _ ____.__________._______.__.._�..____________ <br /> -___-_..___--__.___-'_' --_-_-_'_--_----'_----'_._-__--__-._--_.--__-_-___-__. <br /> '----_ -------------------------------------------� �----_.--'----------'-------''.--'--------___.--. <br /> ordinances,I hereby rtify that I have prepared this application and <br /> ".� egu . <br /> K��+ f the San Joaquin Local Healfh District. <br /> ' ----'-----'-----'----'--'--------'' <br /> (Tif <br /> ` plan, showing ��� u� �t ��wt�n of system �m re�+�nfov'eUs buildings,-----'--''^ --'----------'--'' � <br /> -- em~ can be placed on reverse side). <br /> F O- R.DEPARTMENT USE ONLY <br /> APPLICATION ACCEP TID 3Y------ <br /> - u»/E-_ , <br /> Alterations and/or recommendations:------- <br /> - ` <br /> -'-_----�'-_-''''__-'--_-'--'--- <br /> ' ' -'�---''--'_--�_.--___.__'__ <br /> - --------------------------------------------------- -------- --- -- --' - - '--- '--' ' -- ---- ' - '-- -- --------------- ^ - -- - - --------------------------------------------- <br /> FINAL ' '— ' <br /> RN \L |K0PECTON BY,- '. = - � `�.''-' Dufo-' ----------------------------------------- <br /> - <br /> SAN JOAQU/NLOCAL HEALTH <br /> DISTRICT <br /> mn s=m America" St=et 3noWest Oak Street oz sp,°m"re Street o/+ North ^C^ Street <br /> o*m,��. o"/x","� Lodi. California Manteca. California _ Tracy, California <br /> sS-v_zw B-51 Revised v/-2/00 <br />