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° �PP !��T <�� "SANITATION ����� Permit N �� <br /> 7---- <br /> (Complete in Duplicate) <br /> &,o *�° -�'�ot�e�1 <br /> ,�un6 -5!!rP <br /> ' <br /> Applicationmu6o to the San Joaquin Local Health Districtfon o perm'tf to construct and install the work 6orein described. <br /> This application i, made in compliance with County Ordinance No. 549. <br /> JOB ADDRESS . ' . _ <br /> ------------------------------------------------------------------- <br /> Installation will serve: Residence 1b__1`AApartm'enf House E] Commercial F1 Trailer Court 0 Motel 0 Other 0 <br /> �� ~_ <br /> Number of living units: -� Number c� bedrooms �p Number of 6���, ~./.� L=+ ,�e - __. ---.'-_' <br /> �/_ .. ' -�.. �'--___..`~_- <br /> W� �� Public system �� ,�m � Private E] Do� � �� ��o _' ff. <br /> Character of soil to a depth of feet: Sand Gravel Sandy Loam Ef Cloy Loam El C|a-YE] Adobe 8-nurdpan � <br /> Previous Application Made: Yes E] No 2a-- New Construction- Yes 21,-no Ll � <br /> ~� <br /> TYPE OfINSTALLATION AND SPECIFICATIONS: � \ <br /> \ <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) . , <br /> Septic Tank: from nearest wellisfancm from foun6otionzW10��-_-��o+er�L,.^^-___.�_.--_-_- <br /> [�,�W�u^«­���No. ofoomportnen�-�_-_--...�S�v.�_-._-_---'_Uquid 6au+h-�----�---.-Copvc�y-__-__.- <br /> ' ' ~ ^. <br /> Disposal Field: Distancefrom nearest °aUxo���x�� �n foundation <br /> Number u[ lines ^^ Length uJeach line---------4.�7-------------Width <br /> -24`2�~~' �� Type of filter mat orioL.�_'j?_v_-c2°X-Depth of filter mo+e,iaL.Zd-----------Total length-....ZA---.-_------ <br /> Soopuge Pit: Distance to nearest-well----------------------Distance from foundation-------------------Distance to "vomst lot line_---_-.' ^ <br /> [] Number of pits----------------- -----Lining material -..--------------Size: Diameter-._--.-_Depth--__--..__'- <br /> Cus000 : Distance from neanastw°L--_--Distance from fovndo+ion''������� Lining motoriaL''-_.---''____- <br /> E-1 Size: Diameter_--__-_--_..Dept 6-------------------------- ------------------------Liquid Capacity---------------------------- <br /> Privy:� � ` Distance from nearest well '_'--_''-�'''--------------Distance from nearest building------------------------------------------ <br /> El Distance to nearest lot line- -.. .. -_._ <br /> Rumo6e|ing and/or nepuiringe\:---''' --''--_.--'-' <br /> --------------'�����������������������------'�----------'-----------'��-----''��---- -----------'----C_,_�-----------''------'---'-------------------------' <br /> ._--__.-_-__-- -__---_-'__-__-'--__._-___.-__-.--.____-__-_____.- <br /> ---__--___..'-_--___.__---.___-__.----_--__-_--__-_._'�-_-_---._-_..__---__-___. <br /> I hereby certify that I have preparedAio application and thatthe work will be done in accordance with San Joaquin C*unfv <br /> ordinances, State laws, and rules -and regulations of the San Joaquin Lqcal Health District. <br /> ------------------------------- <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, efc., can 66 placed on reverse side). <br /> FOR DEPARTM�NT USE ONLY <br /> REVIEWED 0�-_---'-_'-- '--�-'--_-_-___-_---__.-_.'''-_--'-- DATE <br /> BUILDING PERWO' ISSUED-'_..��-___.-'_--_-__------._--.__. DATE- <br /> Alterations and/or recommendations:---------------------------------------------------------- -------------------------------------------------------------------------------------------------- <br /> ----------------------------------------------------------------------------------------------------- -''''---''--''''-'-''--'---'---''----'--'----'----' <br /> '---'---------------'-----'----------'------------'-----'-----'-'-----'—'--''' <br /> _�-_-�--^_'-^-�---'����--'�_--��--'^����'��-.---_�-------'-'��--'''__'''_-'--------_-'-''-_-_.- <br /> ___-_---___---_-..___._--__--_---- --.-----_------------_-_-----.-__-_-___-_----_.. <br /> F|N/\L INSPECTION BY: ------------------------------------------------------------ Do+e---`''------'--�-_.'-_''-''-''_________ <br /> GAJN JOAQUU4LOCAL HEALTH DISTRICT <br /> /nn s""m American Street 000v/=+ oak Street o» Sycamore Stree814 North "C" Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> � <br /> ES-9-2M 8,5/ na.ae6 vv-2/00 8 <br />