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^ . <br /> �� <br /> .......... APPLICATION FOR SANITATION PERMIT Permit No. <br /> (Complete-in Duplicate) <br /> Application is hereby made to the San Joaquin Local Heal+h District for a permit to construct and insta ork herein described. <br /> This aPplication is made in compliance with County Ordinance No. 549. <br /> Installation will serve: Residence 2T"�Apartment House n Commercial E] Trailer Court F1 Motel 0 Other ED <br /> Number of living units: j Number of bedroornti _.&.-Number of baths Lot size <br /> Water Supply: Public system 0 _RFAC_ ...__------ <br /> Community system E] Private �4_�Pth to Water Table /0. ft <br /> Character of $oil to a depth of 3 feet. San W Gravel C] Sandy Loam [] Clay Loam [] Clay 0 .Adobe E3 Hardpan C] <br /> Previous Application Made; (if yes,daTe........ <br /> JYPE 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 foLridation.......... Material <br /> Disposal Field: D�sfarice from nearest well,.. <br /> Distance from foundation..... to nearest lot line---m�:i <br /> Number of W;dfh <br /> A DI) TYPe of filter material.A.be- Depth of filter maieridl-... ...........Total length . ............. <br /> Seepage Pit: Distance to nearest well­-__-......._Dfsfante irom founclation.....................Distance to nearest lot line......... <br /> Cesspool: DisfancG from rearest wcll...... .........Distance from foundation.......... Lining material..._ <br /> 0 Distance to nearest lot iine <br /> 1 hereby certify that I have prepared Ais application and fhaf the work will be done in accordance with San Joaquin County <br /> ordinances, S+afe laws. ind es and regulafions of fho San Joaquin Local Healih District. <br /> _ ....._ ==,� <br /> -, CL `w <br /> ---__-'---__-------''' - <br /> (Plot plan, showing size oflot, location ofsystem �'------� '-------'---1/me}-- -- ---_-� <br /> m ~r��o" *, *eU� etc., can be placed on reverse side). - -- ' <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEP'E" "^ .....-+-^ �-' DATE ' � �� � <br /> RENEWED BY-._____________________ ------ �_--'���/�����",�.,'---_ ' <br /> 8U/LD/N6PEKw|T /��UBl-_'_ --'''-- »n/�--'--------'--------- / <br /> Alterations and/or recommendations: <br /> ---------'-----'------------------' D/��'------------------- <br /> -----__-----__............ ..............---_---,'--___-_-___-_-'_-_--_._--___----� --_---_------ <br /> ---,-_---_----.__'--'-__ -_--_--_-'_-,_'---____----_----_-_-__'-----'--___'- <br /> ­ .............'--_ ........... ^--'-............. <br /> e �' _�_-^�c_'r- <br /> .--_''FINAL /N3P6CTxJ _ ] ."' .... ........_.... <br /> _- <br /> SAN JOAQU|NLOCAL HEALTH DISTRICT <br /> 1+01E.xolam"^=. zvuWest Oak u"°/ `z4Sycamore Street ev,w~*v���"w � <br /> ~,~~~California ��. c°o��� <br /> cv,vmw'-p Vonra*p=^ r~ =�� °m~*"o'efornia <br /> Tracy,California <br />