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�� ��� �� <br /> pkx«u~~ x�w ���� <br /> APPLICATION FOR FOR SANITATION PERMIT 6,6 ~7,'� <br /> (Complete in Dup||oafa1 <br /> gK �� is he m� <br /> to ise San Joaquin Loca� Health District for a permit to construct and install the work herein described. <br /> application is made-in compliance with County Ordi nce No. 549. <br /> Installation will serve: ResidenceX Apartment ouse F-1 Comme�cial E] Trailer Court Ej Motel E] Other Ej <br /> Water Supply: Public, system El Community system El Private X <br /> Character of soil to a depth of 3 feet: Sand x Gravel E] Sandy Loam E] Clay Loam E] Clay El Adobe E] Hardpan 0 <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public 200 feet.) <br /> Se f* Tank: Distance from nearest well ----- ion------/__0____.MaferiaI <br /> Piz s Liquid depth------- ------------------ <br /> Va Size--- <br /> El Distance to nearest lot line <br /> Seepage Mt Distance to nearest veL_-_-_--D|danoo from foundation--------------------Distance to nearest lot line----------------- <br /> 171 <br /> _''-'-_171 Number of pits----------------------Lining material Size: c__ <br /> Size: Diameter Depth <br /> Disposal Field. D��n� from nearest � <br /> ~aA ' <br />` Distance. from ��d��' _�� lot <br /> �r' Number of ||n fvach |ine_-'� VkH` of �nm:k— ^«^' <br /> - °Tvpo of filter material par '� '�' <br /> ----- <br /> -Remodeling an6/or repairing (describe): <br /> --'---'''--'--------------- . =� <br /> �~��*� ����'��-'��]p -� _.-_-___.. . <br /> -.__-_--._----_----__--__..___--.____---_-___--' -. <br /> -- ''--.-__-'''__-___'_-_-''___.'''___.-__---_''--''-__----_-___'''-__''''__'_-_-' <br /> _'____..___._-..__----__.____--.__-_-__-----__-----_-_,---___..___.__-- <br /> I hereby rfify that I have prepared this application and that the work will be done in accordance with <br /> --- ~ <br /> -_ Contractor) ' <br /> ' -_� '-''''''(.w�_ , <br /> Rqot �anu o C�r. ocatio system in ��U6�o� of�, must be filed �Owne��and/or <br /> --'-'-'-'---' <br /> ith this application). <br /> ( <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED 8Y_---.. _ -------__- DATE_-- ` <br /> RBUE\�B} BY-------- �-__*��~�����-»���----�-�----- U�TE-_~~�.�� `��------ '- <br /> 8U|LD|NBPERMIT |33UED_ DATE' <br /> ^wrwrmnnnuonu/or ,ecqmmnnmotmns, 1014"+w°u� ' <br /> _ �~ . -------- - . <br /> -----------A _j <br /> ------------- <br /> ----------------------- --------------------------------------------------- --- ------x -------- ---- ------- --- ------------------------------------------------------------- <br /> ------------------------------ <br /> ------- <br /> ^ 71! <br /> �� <br /> ��- __---_-_� -___.-.__-.---.__--_'__-_. <br /> PERMIT � � ISSUED � � (~o� FINAL |NSPB�|� ---------------------------------- <br /> Date <br /> ' <br /> -----------' --' —''-,-~+--' � . .o,�.. ____ / <br /> ` <br /> Du+v '----' _______.. <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT ' <br /> 130 South American Street <br /> S+rc�nn. California ' <br /> s�-�-�� p'so W-1639 ] <br />