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� <br />~� <br /> . APPLICATION FOR SANITATION PERMIT Permit No. <br /> k���n�faln ' <br /> , ��`- ~~r~--' ate |om�e6 ~ <br /> Applica"icin is hereby made to o Sao Joaquin Local Health District for o permit to construct and 'install the work herein described. <br /> This applicationis made in |hu with County OrdinanceNO. 549 <br /> JOB ADDRESS AND LOCATION....-0--k- ......3__e�--------- ----------------- <br /> ContmctorsName--------------------------------------- '_-'''''-'''-- -------------------------------------------- Phone`--''---'--'--- <br /> |nstmUeHonwill serve: Residence Apartment House Commercial F] Trailer Court [] Motel [] Other-El <br /> Number nfliving units: ���4um6or of6e6,00mo 3- Number of baths Z_' Lot size --- -.----- <br /> Water Supply: Public sysfern El Community system El PrivateX Depth to Water Table 2-jq- ff. <br /> Character of soil to depth of feet: 3un6 [] Gravel E] Sandy Loam [-] Clay Loam C|oy [] Ado6elwHardpan [] <br /> Previous Application Made: Yes [] No [] Now Construction: Yes 0 No 0 <br /> TYPE OF OP |NSTALLAJ|ON AND SPECIFICATIONS: <br /> (No sept'im tank or cesspool pa,m|*o6 if public sewer |y available within 200 feet.) <br /> Se ti Tank: Distance from nearest wa .� -.Di,tu -.'14- Mafm ~ <br /> No. ofcompartments-----�/�- ---.Size-�����.A[�����-.06 <br /> qui� eP!k--.���----.<�upocify--��.�^ <br /> (g/ <br /> x| ��J Distance from nearest+ we �"� ------Distance from foundation Distance to nearest lot |i S <br /> Number of linesLength of each |i of french <br /> wv"~~°-�K Type of ��o, m�+p��--_'�---Deot of ��or mv|aroL-'-''�--�o+u length <br /> �-� >4- <br /> Seepage Pit' Distance tn nearest weU --------------------Distance from foundation_--__Distance k, nearest |ofline-._-_- <br /> [] Number ofpits----------------------Lining material---------------------- Size: Diamvfec''---'- ---Depth� --- -- --'-'-'-'- <br /> Cospnp|: Distance from neare5f well. ------- -.Disf ncof"omfoun6at�on------- Lining material--- <br /> S�ze: Diameter'-''''-'_----Depth-----------------------------___----------------Liquid Capacity---------------------------gals. , <br /> Privy` Distancrfmmnaareo+ wuU--------------- --Distance from nearest building----._-_----- <br /> [] Distance +onearest lot line`�'- ------------------ ---------------------------------------------------------------------------------- '-__-_-�'_�� <br /> � -.--___._-�__-_---. <br /> -__' --_-''--''-- '-_'_-''_.-'-__.'_-'-_-''-'---. <br /> ---'-' ----'--~-'— --'--''---'-----------'Qr-------'--'-----------'----------'---' <br /> .--.__----_--_-.-__.----.__-_--_-._--_----_-.-_----_-_--___--__.----_---_-.. \ <br /> prepared this applicationand that the work will 6e done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> (Plot plan, ,Vow ng size of lot, lo tion of system in relation to wells, buildings. etc.. can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> ----------------------- -- ----- DATE------------q------- -------- <br />( Ata +l n6/ 6 H�nx; AIL <br /> ==� --- - - - <br /> 11 <br /> ~r - -- ---- -K��----------- <br /> --'-''-- ' ~~�-_ --'''--'''-_'--.'--'''---'__''-'' <br /> ' -- -----------'°4'------ -'- --'���------{J-------------'--------'-----'-'' )� ' <br /> .u�.�� /��� ���-.���°~/----------------------- - - - - - -- - - - - - - -- - -- - ' <br /> FN/\L INSPECTION 8Y........ .. ---- !----.-----�----__-'--. _-'---------.--._-.� <br /> SAN JOAQUUN LOCAL HEALTH DISTRICT <br /> /o/ South American Street 300 West oak Street /32 Sycamore Street nw North "C" Street <br /> Stockton, California Lodi, California Manteca, California Tracy. California <br /> . =_". ~"°""~""" <br />