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~ <br /> ] ~ } <br /> 0p APPLICATION FOR SANITATION PERMIT Permit No. <br /> (CompV���p�� � <br /> lete Duplicate)` Du*o Issued '~ <br /> This Permit Expires I Year From Date Issued <br /> --' i <br /> Application is hereby made to the Son Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in c9mpliance with County"O- rdinance No. 549. <br /> Contre <br /> Installation will,serve: Residence E] Apprfmarif House [] Commercial E] Trailer Court E] Motel E] Other <br /> Water Supply: Public sys+��m,[]j Community system Private X Depth to Water Table <br /> Character of soil to a depth of Y'I(Iet� Sand D Grav'I E] ,Sandy LoaL El clay Clay E] Adobe E] H <br /> Im <br /> Previous Application Made: Yes L] No 0 New tonstrutficinf� Yes Efl No E] I!,HAjVA,-,,Yes E] No E] <br /> TYPE OF INSTALLATION AND SPECIFICATIONS:` <br /> (No septic tank or cesspool permitted if public s wer is biaila6le 200 feet.) <br /> Septic Tank: Distance from nearest well- <br /> Distance from f[ndaf ion--1�0-----i----Mafer I iai--- <br /> ------------ <br /> '`^^ of "'^'p"'"'="'� � <br /> Disposal Field: Distance from nearest well--5--P.-t, Distance from foundafion-,C�- -------Distance to nearest lot line------ <br /> Distance 46 <br /> Seepage Pit: Distance to nearest ------- 7Z�q -7777 <br /> ' <br /> Cesspool: "'"'a"`= from nearest ==4� ''p= ?"". .""""""." Lining material <br /> I hereby certify that I have prepared this application and that +He work will be done in accordance with San Joaquin Counfyi <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> ------------------------- <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 /> DU|UD|NG PERMIT ISSUED-------------------------------------------------------------- DATE-_------------------------------------------------- <br /> Alterationsand/or recommendations:--------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> ------------------------ <br /> -'----'| --''' ------------------ ----------------------'--'l�r '--'--'-''---�'---'---''--''-'---'--'- <br /> ------------------------------------------ <br /> , --_------.-.----.. <br /> ---------------- --------------------- .......-------- ------------------------------------------------------------------ ------- ----------- ------------------------------------------------------- ------------- <br /> -------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------' <br /> - �—' -- <br /> FINAL INSPECTION BY�-�~�� ----- Dot�------.�����-��-.��../------_._-- <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street 132 Sycamore street ow North "C" Street <br /> sto"kt"". Cala="ia ` California Manteca, California Tracy, California <br />