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/� <br /> o ^ � <br /> / <br /> APPLICATION SANITATION PERMIT� PoWm|t No. <br /> o <br /> ��om � Duplicate) <br /> +a ln <br /> ` -`- - ` Date Issued �~ <br /> Application is hereby made to the San Joaquin Local Health District for a permit, to consf, uct, and install the work herein described. <br /> , This- `..cation - made - _compliance with County Ordinance No. -4' <br /> ___ ADDRESS AND ' <br /> / <br /> \ `'°.=. , .`=" <br /> � -_ <br /> / <br /> Contractor's Name '-_-'--_-''-''-_--'--'-''- Rh <br /> |ndaUatiom+vH- Ros[6a /\porhnen} House E] Commercial [-] Trailer Court E] Motel [] Other E] <br /> Number of living Mimbe, of becI�,com` e Number of baths /--- Lot xba 40-.----.---' <br /> Wafm Supply: Private [-] Depth toWafer Table <br /> Character of sail to a deofli(of3 feet: Sand E] Gravel 0 Sandy Loam E] Cloy Lem [] [lay I-] Hardpan [] <br /> Previous Application k4a6w: Yes E] No J�F New Con��,vo+/on� Ya��� <br /> r TYPE OF INSTALLATION AND SPECIFICATIONS: ' <br /> | � <br /> (No septic tank or cesspool permitted if public sewer isavailable within 200 feet.) ' <br /> W9 compartments ' ' � -'--Capacity----------------------- <br /> Dispasql <br /> Field: <br /> ' Di `. �,n |. � / <br /> ------- <br /> Number' <br /> Length of eachof <br /> °� french <br /> '/,~ � ' --'--^ ~� ^ ~'~''~~�"° ~ ~ �u�� o� �|+er mo�� ' � ��--'Jo�| |en�� '� �' � - '' <br /> ' <br /> Seepage Pit: Diston�No nearest well --_---_[Xstance from foundation -Distance to nearest lot line----------------- <br /> El <br /> .--__.-[l - Number oJpits----------------------Lining material----------------------- Diametor'__.-�'�_Depth--------------------------------- <br /> Cesspool: Distance from no'orov well --'----Distance from foundation--------------------Lining ma+e,oL--_-_.'--'--''_ <br /> Size: Diameter---------------------------------------Depth----------------------------------------------------Liquid Capacity-------------------------_jub. <br /> Privy Distance from well El � <br /> «= � <br /> ----------------------------------- <br /> I <br /> ' ' <br /> ordinances, certify fhat..l h-ave prepared this application and.,that the work will be done in accordance with San Joaquin County <br /> 1?"ws, and u nd regulations of the Son Jo�i`quin Local Health District. <br /> , ~' r~^' ~~~^'� ~~~ ~' ~'' ~~~'~~' ~' ~r^'^ ^' <br /> ^^ ^' .�~'~ /~ ~~^~ ~== ~^,y =~" °"" °= r"^�" ~" '.,~ ~` "��^/�^ <br /> ~ <br /> FOR DEPARTMENT USE ONLY <br /> y . <br /> � <br /> APPLICATION ACCEPTED ------------------------------------------------------------_ <br /> ' <br /> REVIEWED BY----------- -''_--- ---------------------- <br /> � <br /> BUILDING PERMIT ISSUED---------------------------------------------------------------------------------------------- DATE-'«��-------------------------------------- <br /> __-' <br /> Alterations wn6/w, recommendations:------------------ ------------ ------------------------------------------------------------------__.----.____- --------------------------- <br /> ! ---------'--'''--`'-----''-'--'-'--'''--'''---''--'�'--''''''-''-'---''---�'''''---- --''--'------' � <br /> _'--'-'---'_-'_---__.'''''_-.'----'''--'''_-'''-_-----''-_-�''^_''---_'-i--------------------------------------------------- <br /> ------------------------------------ ---------------------- ----------------------------------------------- ------------------------------------------------------------------------------------------------------ <br /> _.�_ <br /> ----------------------------------------------'''`_''''''_-'''--''-'�''-�' --_-'_'''''-'''-_'''''_-''''-_-''---�'-'-'--- . . <br /> ] ` <br /> / <br /> FINAL INSPECTION BY:-------------- D�to ^/�� ~~� �- �� ~- ' <br /> =-'-------------' -'�~- ----''v"----'—`'-----'- <br /> ~ <br /> � SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> /30 South America" Street 300 West Oak Street oz Sycamore Street 814 North 'C" Street � <br /> Stockton. California Lodi, California- Manteca, California Tracy, California <br /> � <br /> ES-'?-2M 8-5/ m°,1soJ vv-2/00 <br />