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-- <br /> � <br /> ' . <br /> APPLICATIONFOR SANITATION PERMIT Penm� No. <br /> `--'� - im Omukca+m' Du+o (nswued �� l <br /> ' <br /> IP licafion is <br /> hereby mm6a to the Son Joaquin Local Health D�f�cf for u penn|+ to construct and install the work hnr�� �^euz6o6. <br /> Thl Sopplicufion is mo6o in compliance with County Ordinance No. 649. i <br /> ' ( <br /> --- ADDRESS_ AND LOCATION _ <br /> _ . <br /> Address --'--' ---' ----'--'--' ---------- <br /> Contractor's Name------ ao&4------------------------------------------- --------------------- <br /> Installation will serve: Residence QT' Aoadmnnt House F] Commercial C] Trailer Court 0 Motel 0 Other L] <br /> Number ofliving units: � of6o6roomo ��' Num6e, of6�+h, -^^. Lo+ ��� -'°���-��-' .�-.--.---- <br /> Water Supply: Public systemCommunity system -E] Private E] Depth to Water Table 25!_0 ft. <br /> Character of soil to a depth of 3 feet: Sand ravel 0 San Loam [-] Clay E] Adobe 0--HurdpaoE] <br /> Previous Application Made. Yes [] No ' Now Construction: Yes 2';l�o �� <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> �No �opf�ctank �, uoospmm| po,miftad ifpu6|i* sewer � ^voUwithin <br /> ' .w~�' / � -- <br /> Sep <br /> o Distance from nearest *mU-�m�------'D|�u f foundation-1��----�� ..^--- <br /> WR~' No. ofcompartments------19---------------size---f 0�P_AFNWo-----Liquid depth-.--d.��---.Capacity-'�6pp---------- <br /> °�- � <br /> Disposal d: Distance from nearest woU'�a��-- .. <br /> --Distance foun��tionZe...-.......Distance tonearest lot line---- <br /> ��_-- <br /> ou�~- Num6er Length of each |i v width oftrench------�2��1------------------ <br /> Type of filter mu+erin|-/'ro,*K--------Depth of filter materivi-�^�7,_'f'-Tota| bmot -----------V-6---___'._- <br /> � 0_a-� �~ ^ � <br /> S : Distance to nearestL �� <br /> wo . 1�.-_ <br /> . Di�anco from foundat�n- _-Distance +o nearest lot | ' <br /> Nmm6a, of pits-------�------------Lining material...A"CK-- Size: Diamator..0-a-11 -----Depth----- ._.__ <br /> : Distance from nearest well ---_-.Distance from foundation����� --------Lining moferiaL--~--'''--'-_.'_ <br /> [� Sizo: D|umafec -----------------------------------Depth------------.�--------------Liquid Capacity----------------------------gals. <br /> '� N <br /> Privy- Distance from nearest wmU----''-'--'�-'�_---��Distance from nearest building ''--'___'--'-'''- � <br /> El Distance to nearest [of line--------------------------------------------------------------------------------------------------------------- <br /> � <br /> Remodeling <br /> __---__--.---___-_._-_--__- . <br /> ---------_---..______'__.-_----------_-----.------------------------'_--__.--------_---.--.-----.. <br /> ---_--_.-------__.__---_____---_'_-____..____-.---------------_-------_-----,--_--------_-. ( <br /> | ho,o6v ^ that | have p,npmn»d this application and that the wp, will be done in muco»Junco with San Joaquin County <br /> StaterulesDistrict. <br /> ,i~--,_- -------------.-'----_----__._`(Owner- and/or Contractor)- _ � <br /> - --------------------------------------------------- ---_.-.. <br /> (Plot plan, showing size of lot, location of system in relation to wells, Luildings, etc., can be " laced on reverse 66e). / <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED B ---------------------------. DAT <br /> REV|EV�ED <br /> 8U|LD|N�� BY <br /> ISSUED----.����------_-----.-.-.--.-_-------.. DATE ' <br /> -- <br /> Alterations and/or recommendations------------------------------------------------------------------------------ ------------.----..,n�'.-__-.-----_-.. <br /> ���-----------------------------------------------------------------------------------------------------------------'-------'���������������������----------------'------' <br /> '-'--'--'-'__--''-'-''----'''--'--'''--''''-_'''''''''''''''-�----''''''----.''''-----__'''--_'- <br /> --'--'-''----'''''''_-'''--''''--''''--'''''^-''-,'''''''--''---'''--_''''''_-.''''----''-''''-_.''- <br /> ------'����'�������'''��'''''�''''---'''�'------''''''---'''' ---'''''-------------'''''''----'''''---'''---------'''������--'-----'' <br /> RN/\L INSPECTION BY:------------ _--.---.- Date------ <br /> -- -------------------------------------------------------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> '',--.___--.--._-__.-SANJOAQU|NLOCALHEALTHD|STRK3 <br /> mo South American Street 300 West Oak Street /32 Sycamore Street x|+ North 'C' Street <br /> Stockton, California LoJi, o"m"rnia Manteca, California TraGYr California <br /> ES-7-2w 6wm/00 / <br />