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~` Permit _- <br /> No. L�=� . <br /> APPLICATIONFORSANITATIONPERMIT <br /> - <br /> / <br /> (Complete in Duplicate) Date Issued <br /> Applica4ion is <br /> ~ ' n6 \n,*,U fhe°n, herein J���bnJ <br /> ,a6v u6 -th 6 Joaquin Local Ho*lHn District for o p�nn� to construct u " . <br /> Owner'sThis application is.made in compliance W�h Countly Ordinance No. 549. <br /> JOB ADDRESS AND LOCATION----- t <br /> Phone-------------------------7 <br /> Installation will serve: Residence X Apartment House [j, Commercial [] Trailer Court 0 Motel Other E] <br /> Number of living units: Number of bedrooms __ N <br /> Wate.r Supply: Public system 1771 Community system C]' Private INk Depth to Water Table <br /> Clay F <br /> Character of soil to a depth of 3 feet: Sand E] Gravel F1 Sandy Loam M Clay Loarn 0 Adobeik Hardpan F <br /> previous Application Made; Yes [-I NoK New Construction: Yes K 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 Distance from nearest well-- --------------Distance from foun afion <br /> eac <br /> [] Number m x»«»'''---'-----'~~' g- - -- 6u| 7otu �»m+6 <br /> filterTotal __.' <br /> Type of e <br /> Number of pits--------7------- --- M' aterial_ iameter---------- - - ` <br /> �4f 'I ti'0 601 - -_ <br /> 'Distance from fo ndation- ------------------Li Tinmfe -------------------------- ------- <br /> Size: Diameter L3 <br /> ' ^~ ' '-- u/mmnuv -' <br /> """ ""..~^` ~ ng- <br /> p�vy: Distance from neo,�� w;U. _ ________________________ <br /> I �uncu +onmund'|of1ie-- -_-`''-''---''-''''--'-'--'-'-'— p. <br /> ~ <br /> El Remo, e Ili"ng a ng (clescribe)-­ ------------------------ -------- --------------------------------------- <br /> ------------------------------------ <br /> ' '__.'-_�_---.----__.'-_'''---'--'___'---'_-''__''_ <br /> -.---___-_--._- � ---'--.--_-._..-_-----__--_--_-.---- <br /> ' ---'---'-----''—'--- �n ,6 with San Joaquin County <br /> -----'---'-'---------'--- 6th� vJ|ca�nn and f�af +hew�� wN �� done accordance I hereby certify ��mf ||` o application <br /> ordinances,= State laws,— and° and regulations of the` <br /> San Joaquin Local Health District. <br /> - ~ - ' <br /> ~-~~t <br /> _ ____________.-_-----'�--..(Owner and/or Con <br /> ~n�^do� <br /> � .-- ------------------ <br /> -------------- <br /> ----------------- - <br /> . '- ' ' ' �' ' _''-'' can n° .��.� �6�.=' -�--- '—�� �� � � size of lot. location of system in relation to wells, buildings, �� �� pwp� <br /> FOR DEPARTMENT USE ONLY <br /> ---------------- <br /> rations and/or recommendati <br /> ' .� -_.-..---- <br /> m»�nm�n�� `r- .� _ _______ <br /> �r-..�=-------'--'---'--' <br /> -------------- -V- -e - <br /> .--'-'-'--'-'------------ � -_ - <br /> � D�+a-- -_-___. <br /> � HN/\L INSPECTION 0Y:----- -- ---- ' <br /> / SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> /»u South *=°riw" Street 300 West Oak Street /32 Sycamore Street ow North "C" Street <br /> m*"�c° California Tracy, California <br /> �»a| California . <br /> Stockton, ����"|° . <br />