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APPLICATION FOR SANITATION PERMIT Permit No- <br /> �^ 8 <br /> x/ ^ ' in Duplicate)` Date Issued 41-J, <br /> cJ hmno6v mo6o to the San Joaquin Local Hoo|H` District for * permit +ocon�r ct and install the wor herein described. <br /> lhi application is madein compliancewith County Ordinance N 1 9 549. <br /> ______ <br /> Contractor's Name--- ------------- ---------- -- ----------- -1--- --------- --------------------------------------------------- Phone74 <br /> Installation will serve: Residence,4,Apartment House E] Commercial [] Trailer Court E] Motel E] Other <br /> Number of living units: N <br /> Water Supply: Public system EVCommunity system [] Private E] Depth to Water Table_.jsv ft. <br /> Character of soil to a depth of 3 feet: Sand (-],,Gravel E] Sandy Loam E] Clay Loam [:] Clay E] Adobe R�-`Hardpan [j <br /> Previous Application Made: Yes E] No Z�-�New Construction: Yes El No oyl�g� <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> No septic tank or cesspool permitted if pulolicsewer is available within 200 feet.) <br /> ic <br /> I F Id. Distance from nearest well-Wrkk—D I stance from foundation 'j7-A"_ Distance to nearest lot line----S------ <br /> Type of fiiter material------I------- -- --Depth of filter material--- Total 7 <br /> ---Length of each line-S)POW Width of tren <br /> Se e Pit: Distance to neare well---9-11.) istance 0 foyndafion....... <br /> e 11 P;ynce to nearest 19-t <br /> lwl� I A0411 5 <br /> Privy: Distance from nearest well '- ----------- ------ ''-'�'_'Distance from naunasfbuilding--'-_''-___.--'-- <br /> [] Distance to nearest |o+ line- ------ ----------------------------------- ------------------------- -------____________________ <br /> Remod, ing and/or repairing (describe):-'----''----''__--_.'--_-_''-_.''__-.'_-''_-''__.__.________.____ <br /> -__-_-__.-_---'-___-..__---__—__-.__-_-_--_-_-.__.-..__--_--.--.-'_..__-.__._-._-__. «» <br /> --''-'---''''----'_-'--.'-'''-_._-__.'----''__.--'-_'''__.'_---''-----'--''-''--''--.''--_-'-_`'-' " <br /> -------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------ <br /> I hereb if that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> , Sfate ia-�,, and rules and re ns of <br /> - n Joaquin Local Health District. <br /> (Si <br /> r�~~^-+'�- ~~- ~ ~ n- A --------�" ^ ' <br /> (Plot plain, showing size of lot, location of system in relation/tLo ]so buildings, etc., can be pl reedon reverse side). <br /> FOR DEKIRTMENT USE ONLY <br /> '-----'---'------'--'-----------'---'---'------'----------'--'--------- <br /> —'--'-''-'-'''---'--''''-'''-'''— --------------- '''----------------------------------------------------------- ------------------------------------------------------ <br /> ----- _��'_--------_-------'---_-----__-------___---_____��___------___-----------_----------------____- ------------------------------ ----------------------------------------------- <br /> - ------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------- ------------ <br /> FINAL INSPECTION BY:.---- ---- --- -'''- Ou��______ �a �� _____________ <br /> SAN JOAQU|NLOCAL HEALTH DISTRICT <br /> mu South *m°,|"a" y+=.* 30D West Oak St, ~» /sz Sycamore Street 814 North "C" Street <br /> Stockton, California Lod|. California munmcw California Tracy, California / <br /> sx--9-2w n°./""6 vv'2100 ' /^ <br />