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~~-~ <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br /> (Complete in Duplicate) Date Issued <br /> plica-lion is hereby made to the Son Joaquin Local Health District for a permi c struct and install the work herein described. <br /> 's application is made in compliance �Yith County Ordinance No. 549. i . 1 . <br /> ----------------------------------------------------------- <br /> DDRESS AND LOCATION_ Z ---- ---- il <br /> Installation will serve: kesidence' 69,- Apartment House Ej Commercial E] Traile'r Co!urt E] Motel E] Other <br /> Water Supply: Public system El - Coml munity system [I Private �bpth to Water Table -------- ft. <br /> Character of soil to a depfh.of 3 feet: Sand F] Gravel E] Sandy Loam El Clay Loam Ej Clay E] Adobe [9--flardpan C] <br /> Previous Application Made: Yes E] No 9----New Construction: Yes [-I No Ll <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> .(No septic tank or cesspool permitted if public sewer is available within 200 feet. <br /> 6isposal Fie'� Distance from nearest well_.,�R.......Distance from foundation----6��"!_.Disfance to n6arest.lot line----47�­ <br /> Type of filter material__Aa------el----- <br /> I hereby c6rtify that I-ha prepar d this applicafi6n and f hat.the work will-be-done in accordance with San Joaquin County <br /> ordinances, State I s, and es nd gulations oftWSan Joaquin Local'Health District.: <br /> (Plot plan, showing size of lot, location of systen�4 relation to wells, uildings, etc., can be laced an reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION,ACCEPTED BY� <br /> RENE\�BJ BY----- ~" '-_,--�—'—�'-'—'-'-''-_.''______ � <br /> BUILDING PERMIT ISSUED------------------------------------------------------------------------------------------------------ OATE'—.---- -- -------- <br /> Alterations and/orrecommendations: <br /> _Alto,uHunuan6/mr :---------------------------- ----------- --- ---------------------------------------- ___-_____________.. _____.. <br /> -'-'__'_-----'''''--.--''_-'_-''--'-----'--''_-'-_.-''_-'-_'''--''--'''----__-'-_---___._-.. � <br /> � <br /> ..........------------------------------------------- ------------------------------ --------------------------------------------------------------------------------- <br /> ----------------------------------------------------- . <br /> - <br /> ------__---_---_---_-----__----------------___---___---___��-----_�-----__---__��___-----_-----__-----__-----___--------__---------------------- ---------------------------------- <br /> * ' <br /> --------------------------------------------------------- ---------------------- -'''_''-'''-'' -------------------------------------------------------------- ------------------------------------------ <br /> -`-� <br /> � . <br /> � <br /> FINAL INSPECTION BY:-'—' U ---------------------------------- - Date.-' � '� - -'-'�-'-'--- <br /> � <br /> ' SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> /»v S~"m American str*of 300 West Oak Street 132 Sycamore Sfre"+ ow mv*h 'C' Sf"ee, <br /> e" Ho". California Lodi, California waoteo". California Tracy. California `~� <br />