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� <br /> �v —` <br /> - -' <br /> '� i 7APPUCATION FOR SANITATION PERMIT Permit No.­15_—_-_ <br /> ._ <br /> `Comoete in Duplicate) <br /> Date Issued <br /> v , �--`--__ <br />� made to the Son Joaquin Local Health District for a permit to construct and install the work herein described.This application is made in compliance with County Ordinance No. 549. . <br /> JOB ADDRESS AND LOCATION------261 <br /> Installation will serve: Residence Apartment House Ej Commercial Trailer Court Motel E] Other <br /> Number vfliving units: Number of bedrooms -Y~Num6er 'of baths J---- Lot size � �� ---~--------- ^ <br /> Water Supply: Public system �m�� �� � Private F-1 Depth to Water Table <br /> Character of soil tomdepth of 3 feet: Sand E] Gravel [-] Sandy Loam El Clay Loam [:1 Clay Ej AdobeK Hardpan El <br /> Previous /\pp||*mf/on Made: Yes 0 N Construction: Yes [] No Elay4"A ~_ <br /> TYPE ��F |NSTALLAT|[}N /�ND SPECIFICATIONS: <br /> � x^ <br /> (No septic ankorcw,sp*oi permitted if public sewer is available within 200 feet.) <br /> T. � . <br /> - <br /> \ - Ui�anca from foundation_------MoteriaL-------_________ <br /> No. of oompo�monfs-_--�----.S�e..__----___�qvi6 dep�h.-----_--Copodty_---_.-- <br /> ' <br /> D�tmnro from nou,e` weU--'—'-Distance from foundation, -''''--'Distance to nearest lot line-'-'-'' <br /> �- Nu/nbor of |ineu-----------------------------------Length of each line---- _Width of french <br /> Type oT <br /> 3 P�� D��uocn h, n�ur�` UA nearest �t � '��- - ' <br /> Number of p�u -- --- Diameter--- <br /> 1w <br /> �mote� �� -�,...Do�+h.. ----------------- <br /> Cesspool: <br /> ----_ «m <br /> Cesspool: Disfvnco from nno"*stwoU-----Distuncefrom fou`6ufion...-- -------'Uni"g mutnrioL-------__._ �� f <br /> [] Size: Diameter _''��-''�- ------Dvof '_--'''''''-''''_-''-Uquid Capacity------------------------­-- <br /> Privy: Distance from nearest well-------------------------------------------------Distance from nearest building--_-'-___--- <br /> El Distance to nearest lot line —'—''-'''--------------------------------------------- -------------------------------------------------------______ <br /> Remo6oiog and/or repairing (describe)-'''''-'''----''-----'__-__.--''-___'__--'--'-_''_____.______.______ <br /> ^ <br /> '--'--''------'------'---''---''--'''''-'-'''--'----'''---'------'''---''--'----''---'''-'-'----- X� <br /> .--_-_------__.._-.__--___..___.----_.-_-'__'--___-___--__.-__-'-__.._--_-_—.. . <br /> --'-'''--'-__.-----''-'''__.',''-_''__-.-_-''-_-___-'--'---'-'--_--'--''_-'-__.-_-'----~--'' <br /> I hereby celi fyl�at I have prepare this application and that the work will be done in accordance with San Joaquin County <br /> ,e5, State ws 4 .j <br /> ordinan, and rulesCand r g la:fions o the San Joaquin. Local Health District. <br /> (Signed)---------------Evv,4 ---------- --------------------- -- -- ----- ------- ----------------------------------------- ------- -(Q"ZtT*VP Contractor) <br /> (Plot plan, showing size. of lot, location of system in r tion to we s, uj os. y <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY---------------------- -------- ------- --------------o-__L------------------------------ DATE--------- <br /> Alterations and/or recommendations:--------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> =� <br /> ---'------'------------'------------------'-----------------------'------------'' <br />. <br /> ------------------------------------------------------- ---------- ------------------------------------------------------------------------------------------' ....... -------__._----------------- <br /> ----_-------_---_------_---____-----_--_-----_____-----____---___--_--___---_�­ _-------­____-------_--____---___--___---------_______-----___---_-----_----------- <br /> ------------------------------------- ''_-''''''--''''--'���—�'--_'''-'''''''-'--'''---'''-''''-''.''---'''-''----'--_' <br /> ^ � -? �� <br /> �/. <br /> RN/\L INSPECTION BY:-------------------------- -----2 ------------ Dote -----_---�-------------.--' <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> /nn sv"m 4m**"°" Street 30D West Oak y*°°+ |»x Sycamore Street mw North "C" Street <br /> Stockton, California Loa/. o"|if="|" Manteca, California Tracy. California <br />