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APPLICATION FOR SANITATION PERMIT Permit No. <br /> (Complete in ln Dup|icote) Dote |osuo6 <br /> Ann||cu0on is hereby made to the Son Joaquin Local Health District for o permit +oconstruct and install the work herein described. <br /> This application is made in complianc With Count OrdinanceN <br /> 9��- ------------- <br /> Installation will serve: Residence Apartment House E] Commercial [:] T hiler Co rt M t I OtherX,, - <br /> hA <br /> Number of living units: -------- Number of bedrooms -------. Number of bat s ---I--- Lot size �-------- <br /> .W.a+er Supply- -Public system El Community systern 0 Private A Depth to Watbr Tzibl.-5. ft. <br /> Character of soil to a depth of 3 feet: Sand F] Gravel E] Sandy Loam El Clay Loam E] Clay 0 Adobet� Hardpan E] <br /> Previous Application Made: Yes E] NoX New Construction: Yes �d No E] <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well- Distance from foun tion---- Mator- I------`�.p - ;y.-.�.2_/ <br /> Disposil Field. Distance from nearest well.,e�kOA*_Distance from foundafion---,q........Distance to nearest lot line---4�_o------ <br /> 11 <br /> Ces,pou|: Distance from nearest well-----------------Distance from foundation--------------------Lining material ----.-------- <br /> [] _ Size: Diameter---------------------- ----------------Depth----------------------------`-----------------------Liquid Capacity------------------------- -qo|s. �� <br /> Privy: Distance from neorey+ woU-------------.--Distanco from nearest building------__----- �� <br /> El Distance to nearest lot line ----- '-''''-'--''--''--,-----------------''-'''-''''-''-''---''---'_— <br /> Romo6eing and/of repairing (describe):-------- -- ---------------- -------------------------------------------------------- <br /> ---------------- --'-------'----'''-------'----------'--'-'----'---'''-------''''--''--'-''--'''---' <br /> '---'-------'-----------'-----'-------------'----''---'-----------------------'' <br /> -------'---'---------'''----'--'------------------'----------'--'--'''-'''-''--''---' <br /> that the work will be done in accordancewith San Joaquin County <br /> ordinances, SfafVlaws, and rules�4andegul t*ons of the San Joaquin Local Health District. <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> ------------------------------------------ <br /> Alterations and/or recommendations:---- ----------- -_-_-_--_--_---___.____.-._________.- ' <br /> -'---'--'-'---''''-'--'''--''----''''—''''--'—'-'--''--'-'---'''---'''''--'---''--'-------'''--- <br /> ------'--------------------------------'---'—'--'---'---------------- <br /> -----------'``--------``---------``�`-`-----'---- ----`�`--­----------------------------------------------------------------------------------------- <br /> -------------- --''.-''--'-''--''' ''''-'-''''_''''—''''--'''-'--'-'''--'-''-'-- <br /> <a� <br /> FINAL INSPECTION 8Y---''''--�'''���.-'-_- ---- Dufv''--/~�—"���-��'��.----''-'---''' <br /> � ' <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> /� s� ��" �� !XI' '30D /� ��� S� owm� � s��o"ao". c°|/f","� ` �d|. o*|wo,"� w""�"°. �°|a�m|° Tracy, California <br /> ss--9-2M /0.52mova^a v/'x|no <br />