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APPLICATION FOR SANITATION PERMIT <br /> (Complete in Duplicate)Application is <br /> ro6v mad e to the San Joaquin Local Health District for n permit to construct and install the work here;n described. <br /> This application is made in compliance with C u ty Orclinance,�4p. 549. <br /> N ---i ---------------------------- --------------------------------- ----- <br /> Owner's N <br /> ame--- AW_1_,0,jAQ-7—------------------ <br /> ------------------------- <br /> Commercial [j Trailar CQurf E] Motel [I Other X� <br /> Installation will serve: Residence E] Apartment House El 10 - -------- <br /> Water Supply: Public system El Community system F71 Private'% ClayF Aclober] HardpanEll& <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: ilable within 200 feet.) <br /> (No septic tank or cesspool permitted .if public sewer is ava --------- <br /> Septic Tank: Distance from nearest well -- - ----------- <br /> mp. <br /> of companmen'^-'=-----------------Capacity- <br /> w' <br /> ��ncv from no�n�t ��U _Di��noe n . Uning material . <br /> ------ <br /> Ceopoo|' D\ ° <br />, rivy: Distance from ,==."". well ''- <br /> F-1 Distance to neare daf ---------------- Distance to nearest I t line--i--------- <br /> See ge Pit: Distance to n:st D.°.a" <br /> Number of pits ing materia�c <br /> ------------Lin 47SIze: Diarneferz-2............Dept k <br /> ^ �o `~'---- <br /> Dis al Field: <br /> Length of each Iine�---is-5p ---Width of trench------- <br /> P9 Number of lines---------------- ------- -------- <br /> Type of,filter material ------------Depth of filter maierial <br /> � '--_-_-'-__.'`,-_.--'- " ---_- ---_.'--'---'-_-__--'-- <br /> ork will be-done in I <br /> accordance with San Joaquin County <br /> | | hereby <br /> ordinan ta U,nan no r ulations o . <br /> ' <br /> -------------------------------- <br /> y:------- --------------- --------V------ --- -------- lls, buildings, etc., must bG filgw�it�=isapplication). <br /> (Plot Plans, s w size of lot, location of system in eiation to we <br /> FOR DEPARTMENT USE ONLY <br /> ------ 1 .� u"'� -`�- <br /> DATE <br /> ' <br /> REVIEWED u'---'--''--'---------'----- DATE '--'---'---' <br /> ''''--'� -----''��-� <br /> 8U|LD|NE' PERMIT |6SUED.'_---__.''�--'�-___''-'---'�-_��'---- ______ _ _~______.__, --''-'-'--- <br /> men6a�onm _-_--''^_---__. <br /> AJ�vaHon� and/or recommendations <br /> �-__-.__________ _________.__�________________-__-_._.__.. <br /> --''__--'__.'-__.'''_-'''-- -..__--_-_''---''---��'--'�'---_--''__-.'-__''--_-'--'--'--'--''-'- <br /> -_._._-_-..__.-._-_--.� �_.''''-�''-_'--..__.--__.---�---�__._---_'___-- <br /> ''--''--''''--'- <br /> � -_-.--''_''-_.'_-.'' ---'_-.'''-'-'�__'''--''--''-_-'''-_.--'�'_--'-_.'' '__.'--'--_''_-'-_ <br /> .-_-_-_-__---���� <br /> -------- <br /> PERMIT No- '- ISSUED----- (Date) FINAL INSPECTION urzi <br /> . , ------------------------------------------ <br /> Date_./ /A / ' <br /> SAN ����)V <br /> |N HEALTH DISTRICT <br /> ' �O^��� <br /> 130 South American Street <br /> Stockton, California <br /> , ss-9-2w v'so v*/639 <br />