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� <br /> FOR OFFICE USE: <br /> APPLICATION FOR SANITATION PERMIT Permit No. ...... <br /> This Permi;Expires I Year From Date Issued Z W-- v_ <br /> Application is hereby made to the Son Joaquin Local Health District for a permit toconstruct.6nd instail the work herein scirlmed. <br /> This application is made in compliance with County Ordinance No. 549. <br /> ........ce- -----------iI. <br /> Installation will serve: Resideric"M Apartment-Hovse E] Commercial E] Trailer Court [3 Motel 0 Other <br /> Water Supply: Publicsystem El Community system Ej Private X Depth to Water Table .43 ft. <br /> Character of sail to a depth of 3 feef:4Sand E] Gravel [] Sandy Loam E] Clay Loam Clay K Adobe 0 Hardpan 0 <br /> FHA/VA:Yes 0 No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank- Di tan nearesf well.... Distance fron Jour.dation._...A4d_..Mq,1ria�... - ------------ <br /> 40.a, 4.0artments-----1-—------- apa <br /> Di 4;�..,a, D' i0steonce0from, nearest well Distance from'foundation...... .....Distance to nearest lot line-.. _—N <br /> 0-5 <br /> I he y certify h ave�prepa red +his application and th�t the work will be don� in accordance with San Joaquin County <br /> 'ordinan 8es, S*a+e la and rules anj�iegulafions of the San Joa4uin Local Health Dis+ri6+. <br /> .I ..W­49,—Z�- ---- --------- - - q . <br /> (Plot plan, showing size of lot, locaflon of system in relation +0 wells, buildings, efc., can be 'placed on reverse side). <br /> FOR DEPARTMENT.USE ONLY <br /> ------------ <br /> -_- .................. ................................. ................. -- -------------` ......................................................................................................... <br /> � .......... _....................------_'- ......................................... --_—._���-.............................................................. _ ...................-.. � <br /> .-.--'---_---'_--_-_--^-_---�_---.......................-'_----_.-__'�_-'--.---_.'--^_---'-........... <br /> ~ <br /> ' � <br /> --.~-----'-'..... .... .................--� - ........................... _--'------''_-'^--_-'---.--_----'_--____' <br /> -°�~ ' � <br /> - ' <br /> FINAL INSPECTION OY�L' ' Date............ .......................................... � <br /> SAN J[AQU|NLOCAL HEALTH DISTRICT <br /> . ^ ' - <br /> ,wm �*a=m° Me. 00 West Oak Street `2^Sycamore Street 20aWest 9*Street <br /> Stockton,California ���/�* 'Manteca,California n��/�� � <br /> m ` � <br /> "= , REVISED B'= °= 3'63 ,.°"". � <br />