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� <br /> APPLICATION FOR SANITATION PERMIT PonnitNo. . ''. ` <br /> (Complete` — in Duplicate)- - Date Issued --�-!'L_-_ � <br /> A�plica4-ion is hereby made to the <br /> � <br /> San Health District for o permit to construct an6 in'stall the work herein described, <br /> T 's application is made in compliance with County Ordinance No. 9. <br /> Orclina ,/No., <br /> Installation will serve: Residence Apartment House E] Commercial [] Trailer Court E] Motel E] Other E] <br /> Numbe'r of baths Lot size 2 <br /> Water Supply: Public systerrX, Community system E] Private E] Depth to Water Tabll//-./--17 ff. <br /> Character of soil to a depth of ifeef. Sand E] Gravel [] Sandy Loam E] Cla " Loam E] Clay E] Aclobe)�f Hardpan F <br /> Previous Application Made: Yes E] NoA New Construction: Yex No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> 4ts,�,rad <br /> Disposal FA,10111d,: Distance from nearest well-----------------Distance from foundation--------------------Distance to nearest lot line---------------- <br /> Seepage Pit: Distance to nearest well-,--'---- --------Distance/f, m-fo dation-,'/0 i......Distpnce to nearest lot line----- <br /> 9 _G_4 V_fo I <br /> —Lmo"--------- -------- --------------------------- --------- -------------------- --------- ------------ ------------------- ----------------------------------------7 <br /> "r, ar <br /> I hereby certify that I have prepared.this applicaf ion and-that the work will be done in accordance with San Joaquin County <br /> ordinances, State lawUnd rules and reigulations of the San Joaquin Local Health Dis+ricf. <br /> (Plot plan, showin size of lot, location of system in relation fo wells, buildings, etc.. can be p ced reverse side). <br /> | <br /> FOR DEPARTMENT USE ONLY , } <br />� ^( <br /> APPLICATION ACCEPTED 8Y.'''-'-''-'-''''''''-''_ _--_----. DATE - -- ~^~ <br /> w~��- �—'� -)F� ''�-'--~------ <br /> REVIEWED BY-------------------- ------'�-'�''''''r-'--'���--_''''------------ DATE'--''-''-_.'---'__-____--_ - <br /> BU|LD|NG PERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE--_---__--.—__.___._ A' <br /> Alterations and/or recommendations---------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> ---------- .-_----'''''--''_-'-'''--'--''_-'---'---''''-__'''''--''''-'-_-'''----__'__.'''----'_-'--__ <br /> ����----'---_-------------'������� - -------------'��������---­­_��������­­­----------------------------------------------------------------- <br />. -_-''--''-'-_---'---'''-''------''--''-''—''-'__'''--'''--''--''''''-_''-__'''-'''--_----- <br />� <br />| —'--'—'--''--------'''-''-'-''--'''-'-'-'''-'-''''''--''''—''''''''''---'--'''—'''--'-----' <br />/ <br /> HN/\L INSPECTION BY::_ ---. Duh,-'�----------&-..---------..--------._----.. <br /> � SAN JOAQUQN LOCAL HEALTH DISTRICT <br /> /mo South A="a== Street 30D West Oak Street mu sv=m"= St=et o|+ North '�C" Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California . <br /> ES-9-2M n°��� vv�/oo \ � <br /> - , \ � <br />