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_ <br /> kUR k)I-FICE USE-. Nr <br /> -' <br /> AppJicafion is hereby made to the San Joaquin Local Healfh District for a permit to construct and install the work herein described. <br /> This application is made in complience with County Ordinance No. 549. <br /> � 5J. <br /> '~.. <br /> ' <br /> Contractor's Name <br /> ' /nv���� m� - � <br /> ��: w�m ����� �� [] � �� [] �� [] Motel [3 Other [I <br /> Number of living units: ....T Number of bedroorns.tg.. Number of baths Lot size ...I&. _40<ejAc&........................ <br /> Water Supply: Public system [] Community system E] Private [3 Depth to Water Table63 ft. <br /> Character of soil to aclepfh of 3 feet; Sand 0 Gravel Q Spdy Loam C] Clay Loam ;�<dy[:] Adobe[3 Hardpan C] <br /> ''--- '`'r~-~^~^ '~~~~` ". yes,date...-----------/ No Now Construction:" <br /> ,mm �1r Nr4900 r*pVv*.Yes[] wo`12~-- ' <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> {Np septic tank or cowop*v| permitted if public sewer isavailable within 200 feet.) <br /> Septi T k, OF <br /> ....Distance from fou a Dis tance to nearest lot <br /> No. of compartments_ _S4e..XdZffl&x__s.4r- iquid cis - ---------- ....I—.Capacityxz- <br /> Dis | |J' Distance from nearest Weil <br /> Depth of filter material.- --------Total length-..------ <br /> Type of filter materi;j�;k <br /> «�~� n: Distance to nearest well-....IA I fromneares <br /> --__-_ _ _.Seepu _4..o <br /> --------- <br /> Cesspool, Dl,*on«n from m=amwt well '- - Distnncwfromfoundation.-__--_Liniom out.eri*|- - <br /> .. <br /> -------'- <br /> [] Size: Diameter.'--'_'_-_----.-..Depth'--_._---'_-----. . ' 8Y. <br /> r�.v` '�qo|6 ��rm` s.,F <br /> " -__----'-----._.-_-_-.Distmncw <br /> from nearest 6v<hdinq-_-_--- <br /> LJ <br /> Distance to nearest lot kna-----'_.-__.__________ -----___ <br /> RemodelingvnJ/o, repairing :..................------------------ ....-.......................... ..._-.......... ......................... _................. <br /> ____ <br /> -----------_-'_----'................................_....................-----------------------'-._-'---_---------------------------_'-_-.-..�_---.-_-_.-------- <br /> - -_----__'-------__'__.______'____-__-_-'__.'..-�.--____-__- <br /> ----.'--_---- <br /> I hereby certify that I have prepared This application and that the work wf 11 be done'in accordance with San Joaquin County <br /> ordinan +ate laws, andvogulations of the Son Joaquin Local Health,District. <br /> - <br /> (Plot plan, showing size Of lot, location of syste in relairion to wells, buildings, ofc.. can be placed on reverse sidla� <br /> FOR DEPARTMENT USE ONLY <br /> FINAL INSPECTION BY:........... ............. Date-. --_-'-_---__-_'- <br /> SAN JOAQUIN LOCAL H~~~^'' "N" <br /> ` CN�� CT <br /> * � 1601 E.nmel*"Ave, 300 West Oak Street <br /> v�^n�"°ore Sir#@^ 205 West 9tmSt°*t <br /> Stockton,California Lodi,California Manteca,California n"cy,xax�=ta <br /> «= " °C°r"D =°""°°~=° ,�"" <br /> ' <br />