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FOR OFFICE USE. <br /> --------------------------------------- <br /> APPLICATION FOR SANITATION PERMIT Permit No. ...... <br />-- ----------------- k--------------------_ (Complete in Duplicate) Issued Date lssue� <br /> .- ­ ­-----I------- This Permit Expires I Year From Date <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and 'install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> JOB ADDRESS AND lLtCATION----- ----------- <br /> Address------------------ ...... -----------;442d------------------------------ -----------------I---------------------------------- <br /> Installation will serve: Residence E� Apartment House 0 Commercial F] Trailer Court 0 Motel 0 <br /> Water Supply: Public system E] Community system [I Private aj Depth TO Water Tab --- Hardpan <br /> Character of soil to a depth of 3 feet: Sand E] Grav�I [_ Sandy Loam [I <br /> Previous Application Made: (If yes,date---------------- I No E] New Construction: Yes E] No [:] FHA/VA. Yes [] No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS. <br /> (No septic "tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well--24712'------Distancp from founclatio <br /> Disposal Field: Distance from nearest well fA---------Distance from founclation.J17------------Distance to nearest lot line..4--------... X, " <br /> Type of filter mai_,`ri* Depth of filter material 4-11 <br /> we <br /> Seepage Pit: Distance to near--. ----------Distance from foundation�e_Q............Distance to nearest lot line <br /> Cesspool: Distance from nearest well---_------------Distance from foundation-------------- L <br /> I hereby certify +hat I have prepared this application and that the work will be done in accordance with San Joaquin <br /> ordinances. State laws, and rules and regulations of the San Joaquin Local Health District. <br /> (Plot plan, sh_�' buildings. efc.. can be placed on reverse side). <br /> By <br /> howing size f lot, locaflon of system in relation to wells, <br /> FO R -DEPARTMENT USE ONLY <br /> —''—'– <br /> � '—''---'''--''''—_.--.'—'''—'--'--'_---''—'''—'–'--.''__.'--_-----__''_—__—.''—'--'--_'' <br /> . --------------------- --------------------------------------- ------------------------------------------------------''—''.--'_—------------------------------------------------------------ <br /> ------------------------------------- --'''—''_---'--�--'—_—'–'---�—''_''--'---'--'—,'---''--_'—''--'---'—_' <br /> Do�� ! ~ |�~�~�` __ ---------------- <br /> FINAL <br /> _______ <br /> RN/�L |NSPECT|(JN 8Y� ------ ...... —,`--_^`_------_'' <br /> ' SANJOAQU|N LOCAL HEALTH DISTRICT <br /> . <br /> 130 South American Street 300 West Oak Street v2*Sycamore Street 205 West 9th Street <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> ' ns v ncv/osD m'59 um 5'6e ATLAS <br />