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�! � <br /> APPLICATION FOR SANITATION PERMIT Permit No. ��^�..19��-. <br /> (Complete in Duplicate) Oofe 'Issued <br /> /-.--_ <br /> Application is hereby <br /> 6e to the San <br /> This application is made in compliance with County Ordinance No. 549. <br /> JOB ADDRESS AND LOCATION--------- <br /> -.-- ---- --k ---jr11 -X ------------------X-7-- <br /> Installation will serve: , Residence [?��Aparfmenf House E] Commercial Ej Trailer Court Motel E] Other [j <br /> Wafer Supply: Public system E] Community sysf6m El Private ±""D�epfh'fo Water TaHe 310- ft. <br /> Character of soil to ajdepfh of 3 feet�,,Sand E] -Gravel E], Sandy Loam E] .Clay Loam Ej Clay E] Adobe &-9-a-,dpan <br /> Previous Application Made: Yes &"No1-z­.1` <br /> ffr New Construction: Yes [A--<' El <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if �ublic sewer is available within 200 feet.) <br /> _ of _',--_n-Is- ...- Liquid .~p.. ^°pa".r <br /> Disposa� Field: Di0ance from nearest well-,,�......Distanc'e from -founclafion---'.Z,��....Distance to nearest lot line.- <br /> Ty pe of filter Depth of filter material---/�F-//--------Total length-------/ <br /> ---------------- <br /> 4. A`�-e; ---------------------74�� -------- �-fn----------------------- <br /> -------------- ------------------------------------------------------------ir�------­-----------------------A---------------------------------------------------y------------------------------ <br /> =" <br /> -'-'--'--.-'''----_-__.'___'''___---_�-''',---'''''''___--_-'''-'---''_-----_-'''-'-''-'---- <br /> (PlotI hereby certify that I have prepared this application and that the w6rk will be done in accordance with San Joaquin County <br /> ordinances, State laws,_and rules and regulations of the San Joaquin LocafHealth bisirlc't. <br /> (Signed)---------J-Foe A a - ) 6f(- -.� I <br /> plan, ^"o.."g s6 of location of system ,n relation nmwells, 9wxmmgs. efc., can be placed on reverse mmo| ' <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED DY--- ------ --------------------------------- -5.g-.---.-_----.--' DAT ------BY-------------------------------------- <br /> ----- <br /> BUILDING PERMIT ISSUED-------------------------------------------------------------------------------------------------- - DATE-------------------------- ----.--_-.___ <br /> Altw,mtions and/or recommendations:--------------. ---------------------- ------- --------------------------------------------------------------- ------------------------------------------- <br /> --------------------------------------- ---------'----'------'--'-'-------------------'—'—'--' <br /> ---``----``````--```---`---``-`--`-``-`````-``--`-````````-`-`````---``—```--'```````----`—``-` <br /> _'----'-'-''''''--.---''''--'--''''--'''`'-_'''''''''''�----- ----- --------------------------------------- -_---''--'-_'- / <br /> '-'-'-'----''''--'�-�''--'''''—''--''-''--'''''---'''''''''—''''''--'--'''-''-'-''-''--'--- <br /> ' \ <br /> FIN/\L INSPECTION BY:-----.!�k�L /��'--- Date /��/..�.3----------- <br /> ---------------------------- <br /> SAN <br /> / <br /> \ , ___'''r7- - -'''--'-''------ <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> /xo South American Street mmWest Oak Street /vz Sycamore Street 814 North "C" Street <br /> Stockton. California Lodi, California w^"mpa. California n°"» California <br /> ES-9--2w 10'52 no./m6 vv'x/nu � <br />