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FOR OFFICE <br /> OSE: j <br /> APPLICATION F-Ok-SANITATION PERMIT Permit No. <br /> ApplicAon is hereby made To' the San Joaq6in Local Health District for a permit to construct and ins-tall the work herein described. <br /> This o�co+� made � <br /> � � � ' / <br /> , <br /> JOB ADDRESS AND ~~~~�'~'`' ......^^~~ ~^~~~^'~~~~~~~-'--T-------------''-------'-----'---' ' <br /> ' <br /> Contractor's Name-----------D��ta ic Tank Service, <br /> Installation will serve: Residence -- parfment House -- Commercial -- Trailer Court -- Motel -- Other --Water Supply. Public syste Community system [I Private F-1 Depth to Water Table ds5-- ft. <br /> ^ <br /> � <br /> Character of soil to a depth of 3 feet: Sand E] Gravel 0 Sandy Loam [] Clay Loam [I Clay E] Adobe[:j Hardpan E] <br /> Previous Application Made: 'Ilf yes,date--------------------) No R1 Now Construction: Yes D No [] PHA/VA: Yes No 1:j <br /> TYPE <br /> OF INSTALLATION ° <br /> (No septic tank or cei-ipool permitted if public sewer is available within 200 feet.) <br /> Disposal Field: Disfance I from nearest well <br /> Distance from'foundat-ion <br /> Distance to nearest lot line----------------- <br /> �^��a��f�� �or ` _Widthof trench <br /> Or <br /> Seepage Pit! Distance':to nearest well---- --------Distan(fe from foundation---1.0!---------Distance to nearest lot line--------5 r <br /> �� �� Prepared plication and thatthatthe work will bedone inaccordance withwithSan JoaquinJoaquinCountyCounty - <br /> ordinances, State |a*s, and r`ulen-and regulations ofthe San Joaquin Local Health District. <br /> - <br /> ��nm6L.''''--.' ' �_ 'S��� ' l-_''-.�--'--'''--_' and/o, Contractor) <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> nc,/E=Eu o/----------------------- <br /> -.---...---_-._-''------'�--''--'''-'-' ""'�'----''---'-'------___- <br /> �� g�.'-''-_-_-'_''-''-''-_-'- <br /> ' <br /> ---- <br /> BUILDING PERMIT ISSUED-!: <br /> -----'`'__--'------''-'''�-''-_''�--''''---- <br /> Alterations and/or mncommmn6mtimno:. - ---------------------------------------------:---------------------------------------------_ ------------------- ------------------- <br /> ----------------- <br /> - <br /> -'�_�-"--.-�'�'-"'1'�-- � - - - <br /> -- --/--_--'-' <br /> --__.-_-_'.-_-_ <br /> � �� �--_-----__.. - _ ��� <br /> ----- <br /> ------------------------------------- -------------------------------------- - '---'-''''''_-'''_--'-'--'---'---.- <br /> ----_����_------__-----------------------____---___-------_---- ---- ---__---___-----__-------___------'_---------_------_____-----___-------__---_-------_---__--------- <br /> _ <br /> FlNAL INSPECTION BY:E_ Du+o'-.l-- --- ----------------_- <br /> .. <br /> ` SAN JOV\QU|N LOCAL HEALTH DISTRICT <br /> 1'*South American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street <br /> Stockton,California ; Lodi,California Manteca,California Tracy,California <br /> =.""",.="~"",.°C=""°= .. <br />