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' <br /> � <br />- <br /> APPLICATION FOR SANITATION PERMIT »7 ' <br />` in Duplicate) <br /> Application <br /> is ho,e6v made to the Sun Joaquin Local Health District for o permit to construct and install the work herein described.', <br /> This application is made in compliance with County Ordinance No 5 9. ? 1_� <br /> Installation will serve: Resi4LJ Aparfme ouse E] Commercial Trailer Court E] f I F] Other E] <br />� <br /> Number of living units: TV Number of bedrooms 0 Number baths [Z Lot _ <br />/ <br /> Character of soil to a6ept6 of feet: Sand [] Gravel [I Sandy Loam E] Clay Loom [] Clay [] Adobe EZ/Hardpan [] <br />| ' <br /> TYPE OF INSTALLATION AND SPECIFICATIONS:. <br />' (Noseptic tank or cesspool permitted if public sewer is available within 200 feet.) <br />} 3e nk� Di����oo from noun,a+ �vU / ��_D�v+unce 4 |un . ��, 'k�ut��� -'-.. <br />. , - -���-_ �� , - <br />' N � compartments Cm S�_� �����_L� � 6�� <br /> �� o. compo e --_«~�.--- puc/ry�����*�_.- .0 �_��-.--_..fc-___ <br /> Ceo 000l: Distance fr*om nearest well-----------------Distance from foundation--------------------Lining mafohoL--_-_--__.._ <br /> E] Sizv:'Diamoh,c _--___--_--_Depth---___-..___--..____- <br /> Privv Distance from <br /> "nooros well------------------------------------------------- from nearest building ��-'�--'--''-�' K� ~ <br /> -[� Distance to neo"oyflot line__----------------------------------------- <br /> Seepage Rt: Distance to nearest well----------------------Distance from foundation-------------------Disf noa to nearest lot |ino_�~_. - <br /> [] Number of pits----------------------Lining material----------------------- D|umetoc__-___--Depth..__.. __' - <br /> / [�, F�|6: Distance fro � |in�_.J��'- <br /> \ �� <br /> Number of | of each | -- Q Width nf +nenck-'��------------------------- � <br /> Type of filter mofo���&���. o+ of filter muto�aL__-K-.._' ` <br /> Remodeling and/or repairing (describe):---------------------------------------------- <br /> .-___'-__-___-___-..___._..___.--__--__-__-___---_'-_''----_..____._'____- . <br /> -_____.____-_______-_-_____.-___.--___'--_---___-___''--__.---_.--_-_..__--____- <br /> _-----_------------_----------'-----------___---------'----_�------_----------_____------'__--------------------------'--------------__-----------'---------_-----_------_ <br /> | hereby certify that I have prepared this application and thatthe work will be done Amaccordance with San Joaquin County <br /> ordinances, State law*, and m\eu and regulations of the San Joaquin Local Health C4sf,icf <br /> ; (Si <br /> tJ$fstem iWnrellation to wells, buildings, etc., must be fil d-wit this app ication). <br /> (Plot plans. s ffon�gs' e of lot. oca�',� o e <br /> FOR DEPARTMENT USE ONLY� <br /> A---------- --------------- Tgl� :__V <br /> ---'---'--------'---------''--'-'—'--------''----------''----'----'--'------------- <br /> ---'---------------------------'----'-----------------'------''-----'-----'--'--' <br /> ------'�---````-------------``----------'---------``------'`--------'---`------'--``---------```------'`--``��'--``���-`------'`-----------``-----``---------``---------`---- <br /> ~ --__-___-----__----__.-_..___..__.-.-__------.-_---..__-_-_--------_-.__'-___-._-_. <br /> PERM|TNo—Z�2_ ----- |S3UBD------------------------------------------(Dote) FINAL INSPECTION BY:------_--_--_-___-_.—.. <br /> ' Dafe-''-_.--_.-'-'__.-'-_'-'-_''--'-_'_ <br /> SANJOAQU|NLOCALHE/\LTHDI8TR|CT <br /> ` |30South American Street <br /> . <br /> Stockton, California <br /> U ss--q-2w 9-50 W-1639 � <br />