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^ <br /> ~�� ^ <br /> APPLICATION FOR SANITATION PERMIT "~ Permit No. -------- <br /> (Complete in Duplicate <br /> -- <br /> kComnlefninDuplicate Date Issued' MOO <br /> Application'- hereby <br /> � modo to the San Joaquin Local Haa|f6 District <br /> 6zru permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 5 <br /> 49. <br /> X7--------------------------------------------------------- <br /> Owner's .,~._ - -- <br /> Phone- <br /> Address <br /> /�6� �..___'__ _�--'-� - <br /> - ` ` .. ._ r�one__-_--_-__-_-- <br /> Comt�cto/s Name _-'---__-'--_---_-_'--'-'' '---_-'-,' <br /> Installation will serve: Residence artment House E] Commercial [] Trailer Court El Mofel El Other El <br /> Number of living vni+,: -'_. Number of bedrooms ,�2-mumb -�� `o. ,."= '~~-.�a�,_-_--_. <br /> W�, Supply: Public ��mCommunity system F-1 Private �AoF� to Water Table ~��� <br /> Character ' 'm�| to a depth of | feet: Sand Gravel06ondy Loam [� Clay Loom E] C|uy [] �6o6e ��� Hardpan <br /> Previous Application Made. Yes 0 N r��' Na~ Construction: Ye; F] No <br /> TYPE OFINSTALLATION AND SPECIFICATIONS: ,(N ol septic .` <br /> k or cesspool permitted if public seweris available within 208fl <br /> Septic Tank: Distance from nearest well-(9-1-r_ istance from foundation---------- - -_.Material------------------------------------------- <br /> Distance from nearesf well.Ya___­Distance from foundation t­ nce to nearesf lot Ii <br /> Type of filter material---------- 1--------O-Depfh of filter mi3ferial <br /> El <br /> ------------ <br /> --------- ------- -----g)al5 <br /> ElA ---------- <br /> ~="""=^ <br /> I hereby certify fha have pre ared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, an rules an . regulatio of e San Jo quin Local Health District. <br /> (Plot plan. showing size of lot. location of system in relafion to wells, buildings, efc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY - <br /> ---'--'-----'---------'--'------------'--------------------'--------'----'--------'------ <br /> _--_.__—._-._--'.--'_____'-._---_._-_--_'----'-'_'__--.-_..__.-------__--'_-__._-_-' <br /> Duto- /^��~-�`�� ^ ----------'—' <br /> FINAL INSPECTION BY�--L^�~�'.'---'�-'—'-------- ��' ----7-'' <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> 300 West O" S�°� |oz Sycamore Street 814 North "C" Streetooso�� �=°�«"" Street " <br /> Manteca, California Tracy, California <br /> Stockton, California Lodi, California w" . <br /> ` ^ <br /> ES-9-2M 8-5/ K°,isoJ vv-2/00 <br /> ���� <br />