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' - -v - ~~-------- <br /> APPLICATION FOR SANITATION PERMIT Permit No, � <br /> (Complete in Dwp||um�� <br /> ' Dofo |x,uo6 <br /> |!� <br /> Application i, hereby mu6o"fn the Son Joaquin Local Hso|+h District for permit +vccm,+rucfun6 in��||+k vu� here'Odescribed. <br /> Thi | <br /> nance No. 549. <br /> JOB ADDRESS AN 0 <br /> Ph <br /> Installation will serve: Resiclenc4l Apartment House E] Commercial n Trailer Court 0 Motel Fj - Other E] <br /> Numbor�_of.iiving uniti: _1, Number of bedrooms -4-.. Number of baths .12�-t-ot size7;4 <br /> Character of ,oil to a 6epthlof 3 feet: Sand O Gravel O Sandy Loam D Clay Loam L]� Clay D <br /> ` �p6�~�ev�u Application kw6m 'Ye, - Construction: Y�, No -�-' Hardpan � <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: ^m�~�v��' -~ <br /> : `w <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> ' <br /> Septic / x <br /> of Size_ <br /> . ' <br /> Disposal <br /> W . -(Y4-aj <br /> # Orn er oi lines_Li�...l------ I-ngth of each line---- oe,&_'7� --------Width of trench .... .. <br /> ------------ <br /> 0 Type OT i!fer <br /> - , ___..... .~ g. -.--.---_--. <br /> page�- Pit: Disiancoto nearest woU--__'--Distance fmm �mn6u+iz�-''_----Di�ovcoto nearest kzf line <br /> ' <br /> f4eeFl Number nfp�s----_-Un�g mot �aL-.----'S� c <br /> o� Diu��fo ' -_—' -.� -_--'_--- <br /> Cesspool: Db| nco'from nounsd well---------- Distance from <br /> -` --'---- ' - ~---~------�f-o-u-o6-n`+-ion----__�- Lining mu~fu . <br /> -------3�*' Diameter u;d Capacity..... <br /> Privy: Dismnco�'n,m nou�o well__ --'D�ance from nearest 6ui��g_-_--'_ <br /> LJ Dbfonoe+o nearest lot |��_______________ __...____ _------------ _ ................ <br /> -_- <br /> --_-- <br /> � <br /> r�L <br /> � <br /> Remodeling and/or .wpuirlj (describe)----'__-'_--__--_..-__-_--_'-------'_----�--'--� <br /> . . ............................................ ------------ __-...... ..............---------............................................................. -_' <br /> ----------------------------------- ------ '_____-_----------------- _-------- _____'____ <br /> ` _____.____.____$ ________________________�---'---'---'----'---'------------� <br /> . ~| app ' <br /> ordinances, State laws. a rules and regulations of the San Joaquin Local Healik <br /> - on and that the work will be done in accordance with San Joaquin County <br /> ' <br /> pqnw�. <br /> ~,=~_ ------------------ _- _____ -----(Owmer am6/v, <br /> By:._'�---,-- '_--'-----'- —_-_._.-'-_ ' - (T�eL � <br /> (Plot showing location ofxys�vn � ,o��nntm *�L, buildings, o�� can <br /> `6uplaced.'---�pn ------------ --'' ---- --� <br /> everse ' <br /> FOR DEPARTMENT <br /> APPLICATION <br /> ` <br /> REVIEWED � DATE ^ <br /> --------------------------- � --- <br /> ---- <br /> BUILDING �~ ' ----'BY--_­ <br /> DATE. <br /> .� _--.................... <br /> ' <br /> -- � ___`___� ____�_ <br /> ..,,�.l. _-�_. <br /> , _�—__ '_-_- <br /> __-_AKnr��n m»6/m' recommendations <br /> . _____ _ _ --''--- �- -----''---------- ---.-_- <br /> ----'-----'---____ _____________________. —' — --__-.--_- - -..-_-� <br /> '_—_-__�- <br /> .' <br /> �-_.---__—_-_'-�--'---'---_-__----_._-'_---_--''-__—,_ ' <br /> '_------'-_'----_ ----_'-'----------''--------------------------------------------------------- <br /> FINAL <br /> -__-'_--'---_ --- <br /> �NAL INSPECTION 8Y'- _��°c ---'�..�—r�-�----- Dot�--- <br /> SAN JOAQU|N LOCAL HEALTH DISTRICTii/3n s"�h A�"�=" s�°� am+�+ Oak ��^ /32 Sycamore s*e� m* w"�h "C «*°��w�"� California Lodi, California w^^�� c"w*m� Tracy, California" ' <br /> ES-9-2w10 57 x°,;s"a W-2 100 <br />