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_APPLICATION FOR'SANITATION PERMIT <br />(Complete in Duplicate) <br />Permit No ' <br />Date Issued <br />-16 <br />` T&plicafion is hereby made �Distrapplication is made in complia6ce with County Ordinance No, 549. <br />ic+'for a permit to construct and install the work herein �escribecl. <br />'' <br />�Joaquin Local Health <br />Address <br />Installation will serve: - Residence Eff-"Apartment House F <br />I Comm&cial E], Trailer Court F] Motel [:1 Other [:1 <br />Number of living units: j---- Number of bedrooms W/mber of baths Lot size ....... <br />Wafer Supply: Public'system P--'C'-o <br />mmunity system El -,--Private El Depth to Wafer Table 36' ft. <br />Character of soil to a depth of 3 feet: Sand F] Gravel , [] Sandy Loam E] Clay Loa <br />Previous Application M . ade: Yes E] I �1. m [-] Clay E] Adobe [a-"Aarclpan <br />No 9; ---New Construction: Yes 2 --No E] FHA/VA: Yes E 1�o E] <br />TYPE OF INSTALLATION AND SPECIFICATIONS: <br />(No septic tankfor'cesspool p6mitted if public sewer is availa6le within 200 feet.) <br />P -, a,nk:' Distance from nearest well ----------------- Distance from foundation -------------------- Ma'terial <br />------------------------------- <br />Seepage��ifq Distance to nearest w0�'-__')_­r­.i­N ..... Distan`cEi from -fou'ri daf ion- _,�'70 ---- 1-­Disfanje to ne'aresf lot"lip ----- 6 -------- <br />Number of pits <br />Remodeling an�/or repairing (descrike): ------- <br />----------------------- <br />I herelay certify that 1 -have pre-�arecl This application and7thif the wo:A-will be don-e'in- acc6-rdaince "with San Joaquin County <br />ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br />(Plot plan. showing size of lot, locatio6 of system in relation to wells, 6uildings, efc., can 6e placed on reverse side). <br />FOR DEPARTMENT USE ONLY <br />—_---_.___.------_—__—'�--.----_---_—.—'_.--'_—_--_---_-_.__.—_--_—_.._-- <br />-�--_'---'__—'__---- ----''—'''�'—'''--''—''—_.'''—_.''-_''--_''—_--'-_--__'---'--''—_--__.'_—' <br />-_—_--..__--.__---_.—'`—_-----_------_------_----_-----_---.—.---.--.--' <br />-_'—'—'--''''--''—''—'''_�'--.'_'��---'—''----'—'---_'''�—''''_''_—'''—''—'--'—''--'--'_—'-- <br />FINAL INSPECTION BY:- --------------- ------------ <br />��' —'���'— —''—'--�'---'----' <br />SAN JOAQU|NLOCAL HEALTH DISTRICT <br />oo South American Street svoWest Oak Street /oo Sycamore Streem* m"*h "r' Stm=t <br />Stockton, California | ��J� California�*n��u California <br />, . nvnmpv. California <br />�~1 <br />�. <br />�| <br />