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-- — <br /> \ � <br /> \ � ' APPL CATION FOR SANITATION P������ Permit No <br /> � . — - <br /> ~ <br /> (Complete in <br /> Duplicate) Dofn |oouoJ ----./ — <br /> /« ^ <br /> ~ o to the San Joaquin Local Health Distric+ for* p*nni+ to construct and install the work herein described. <br /> This application ismudein compliance with County Ordinance No. 549. <br /> JOB ADDRESS AND LOCATION.. 6L, ___ -------------------------------------------------------------` <br /> , <br /> Installation�will serve: Residence Apartmenf House �jommercial A Trailer Court 0' Motel [I Other 0 <br /> mumoornrliving units: -------- Number of' <br /> bnLom, --' Number of uo*a Loflsize X ------------------- <br /> Water <br /> .—_--Wmte, q ply: "Pu6kc ',y�itom 0 Community system [] Private F] Depth to VVo+er Table4'�» fL <br /> Character ofsoil to a depth of 3 feet, Sand E] Gr6mA [:] Sandy Loam 0 <br /> - . . C|~uy Loam E] �� [] <br /> Hardpan <br /> P�v�u . . Mm6s Y� 0 Cu�m��n� ,Yo, �] N � o [] <br /> ~� <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: � <br /> (N* septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> / Tank- � Distance from n/, <br /> urusf woU.,-------Distance from foundation-------MuteriuL----__. <br /> Nu cfcomport — __._. _'_ <br /> � __—_—_'— -----'—.`� p �y--�_____ <br /> Field: D�tunce from _ <br /> ' <br /> nown:� �e�'---'D��nce from foun6of�n'--''—_—D�t Distance h, nvure� �� ||m�-----__ <br /> Num6er v{ |invs--------------- Length of'avch line------------------------------Width of trench----___—___ <br /> Type of filter m°feriaL-------Dupth of filter material ----'^'�Total length--------_—_._. <br /> SeePit' Distance to nearest ` ------Distance from foundation--- ' to nearest lot <br /> ANum6ur of mate�a| .I�r: O�mnfer . <br /> . ��t?.,........Depth---' Z��----------- __ <br /> ce0000: Distance from nearos weR------------- ---Distance from foundation------ ---- ---'_UningmoteriaL—''—���______ �~ <br /> F1 S�ze:.D;ame+ec', -------------------------------Dupfk '—'''�—''''_----'''—'Liquid Capacity---------------------------- <br /> Privy: Distance from nearest well----------------------------------------------'Disf no, from nearest 6uU6ing'--'_____________ <br /> [] Distance to nearest lot |'Too—----------- ----------------------- <br /> ----------- <br /> ^ . �� <br /> Remodelingand/or repairing (describe):--------------------- --------------------.--------------------------------- .—----------------------- ----------------------------------------------- <br /> -------------------------------------------------------------------------------------------------------------------------------- <br /> / ' <br /> '—''—'--'''''''—''--'-------'—'---''----''—'''--'----'--'''--''---'—'—'—'—''--'--'--'—''^'—'—'— <br /> .---.—_—_----_-----_.-__—_____.---___—_—'—___--_—.__'-------'_--._.— —. <br /> I hereby certify that I have prepared-this application and that the work will be don-e in accordance with San Joaquin County <br /> ordinances, State laws. and rules and regulations of +he San Joaquin Local Health District. <br /> (Signed)-------/� SZ--- ......�; _ ------------------------------------------------------- --/---.(o er and or Contrac or) <br /> (Plot plan, showing size of lot, locatio'n of sy in relation to wells, buildings. etc., can be placed on reverse side). <br /> om <br /> FOR DEPARTMENT USE ONLY <br /> ---------------------------------------- <br /> r --------------- <br /> FINAL INSPECTION — ------ --te------------�`�r------'--- <br /> ~ <br /> SAN JOAQU|NLOCAL HEALTH DISTRICT . <br /> /on South Arn°r;"a" Street omm West Oak Street /sz Sh=="m ereef u/+ North ^cr' Street <br /> sm"l+"". C°/alo,"a Lo6|. C°}aornia Mwolewo. C*|Komie T,mw. C°lif*mia <br /> � <br /> »\ � ""—°—"" `~°^~~"=^ 1111 <br />