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' <br /> '"" "'' '`^ "^E' /APPLICATION <br /> CATION FOR SANITATION PERMIT <br /> This Permit Expires 1 Year From Date Issued <br /> Application 'is hereby made to the Son Joaquin Local Health Distri�f for�a permit tto,construct and install the work herein <br /> described. This application is made in compliance with County Ordinance No'.'549 �nd existing Rules and Regulations- <br /> License # Phone <br /> Installation will serve-. Resid,6-ncf 'partment House-E]lCom"mercial �EjTroiler Court <br /> .El Peat Son y <br /> L -.Character-of-soil-to-a-depth of-3-f6et.. Sand' —Silt 0 Clay Loam D <br /> Hardpan E] <br /> (Plot plan, showing s A ize of lot, location of syster;lin relation to wells, buildings, etc. must be' placed on reverse side.) <br /> NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feetj Ile %Nl <br /> PACKAGE TREATMENT SEPTIC TANKf I Size--- Liquid <br /> 4 1�z <br /> Distance to nearest: Well ------ Foundation -i;p'�-e <br /> Rock Filled Yes 21INo [I <br /> I hereby certify that I have prepared this application and that the work will be done in a to <br /> County Ordinances, State Laws, and Rules and Regulations of the San Joaquin Laical Health Dis.trict. Home owner or licen- <br /> sod agents signature certifies the following: <br /> "I certify that in the performance of the work for which this permit is issued, I shall not employ any person in such manner <br /> as to become subjject_!pW?4rman's Co ensation laws of California." <br /> (If otheybon owner) 0141 M:0 <br /> FOR DEPARTMENT USE ONLY <br /> DATE <br /> ---------_--- --.--------------------_-------'_-----.-_.—_.. <br /> —_.. —'--'---'—_—.---.----_ --------------------- <br /> ----------------- <br /> Doe <br /> —'----. <br /> -----���� ��� Do�� �� ���,��~~� <br /> �no| inxpec�on6y. — '_---_.---'----'—_--- ��" '----- <br /> SAN J{}AQU|N LOCAL HEALTH DISTRICT <br /> EH. 9 l''88 Rev. 5M <br /> _ <br />