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FOR OFFICE USE: <br /> APPLICATION FOR SANITATION PERMIT Permit No. <br /> ............... .'� .'.... ...........�_ <br /> ......... (Complete in Duplicate) Date ('au�6 ' <br /> _._ ...... ...- ��- u�- 07 '.Cc<; <br /> re-in described. <br /> I lication 'is hereby made to the San Joaquin Local Health Di5tricf fore permit toconstruc�_a install the work be <br /> r�lspapplicafiion is made in compliance with County Ordinance No. 549. X <br /> Installation will serve: Residenc partment House [I Commercial E Trailer Court [3 Motel [] Other F] <br /> Water Supply: Public system El Community system C] Private 01, Depf� to Water Table -M-f-t <br /> Character of soil to a depth of 3 feet: Sand E] Gravel [I Sandy Loam'[] Clay Loam [] Clayik Adobe 0 Hardpan <br /> Previous Application Made: (If yes,date--------- ---------.) No [� New Constructlon: Yes x No FHA/VA: Yes [] No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> 04n septic tank or cesspool pwnnit+m] if public sewer is available within 300 <br /> -- 'Septic-Tank- -Distance from <br /> nearest w�L-&��� <br /> L - ` �� ��No� of �m��men+s 6 ' h ��C �� <br /> - <br /> r--- <br /> �' | �66� Distance nearest ��U-�\;�-. <br /> �,�6 ~J <br /> mof - ��g� ofou�Distance from foundation m �n*ncn-�^�.zc'-__-_� ~ <br /> �-� <br /> Type of ��+e, m�+*r�� /' <br /> ��a�� �� 5|+�r �v+e,ioL-/.!�. --To+ | �o��r -_. ��/�---'_-�.___� <br /> Seepage Pit: Distance to nearest °elL-._-__�Dis+unce from foundation....................Distance +o nearest lot <br /> Numbo, nfpits-------'Lining motaraL__----.S';zc: Diameter.......................D«p+ . .......___-------__'.-Privy: Disla�`ce­T-ror­n-Tecrest .' <br /> ~== <br /> -- <br /> Remodeling ancl/or repairing (descri6e :--------------- ................. ------------------------------------- .....................................--_-......................... <br /> --- ~1 <br /> .............--_-'-_----------------------....-----------------------------......................................---_-- -------.......... .......................... -......... <br /> __ ` <br /> ........-1 ------------------------------------------------------- .................. -__-.- <br /> .---__---.-_'-'-__-__.-__-__-_._---__-_-_-'-_-_-'_'_---'__-__.._--'__-_-' � <br /> hem thwork will be done in accordancewith San Joaquin County ^ <br /> ordinances State laws, and rulef and regulations of the San Joaquin Local Health District. <br /> in relafion to wells, buildings, efc.; can be placed on reverse side). <br /> plan, showing.__-- location _system-_� <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED Dl-__----.._-..-_--------------_ ................................. DATE........................................................... <br /> REVIEWED BY--- <br /> --_'--_-_--_--'-_-__'-'_--'_-__-_----.-__.__--_.__-_---_---_-___--_--'_---_-__ <br /> .................. ......................... ............._ .........- . ................ .............................. _ ......... <br /> -_-'-_~__ <br /> -_-___-_-�---____.-_-'----- <br /> � <br /> FINAL INSPECTION _ ' - {��e'--'/.--/'��-'.�����--_-- .............. <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> 16w` E.x=e/*~Ave. aouWest Oak Street ,z«Sycamore Stroe, zo,West°mStreet <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> E" ° °,,.",D a_^° 3M 3-'62 F.P.C". ~~m� <br /> � <br />