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- <br /> APPLICATION FOR SANITATION PERMIT Permit No. Ja_ /O '_ <br /> k��mm�f* in /m/ <br /> Du+o Issued -'�!/,�'}' <br /> Application <br /> is hereby made to the SanJoaquin Local Health Districtforupermit toconstruct and install the work herein described. <br /> This �pp|applicationapplicationismade incompliance � <br /> compliance with County Ordinance No. 549. <br /> � <br /> JOB 8DDRBS �D �C�|DN__�.�� <br /> ^ =�-.. <br /> [Jwner'` Nome ��`��� ^ ----'' <br /> '---''~~ -~^�~�=*»'�---------'---------------------------- Phone <br /> ------------------------------------ <br /> Installation will serve: Residence Apartment House El Commercial E] Trailer Court E] Motel E] Other F-1 <br /> Water Supply: Public system E] Community system El Private X Depth to Water 'Table ZrTit. <br /> Character of soil to a depth of 3 feet: Sand C] -Gravei E] Sandy Loam 0 Clay Loam E] Clay E] Adobe 5Q H6rdpan E] <br /> Previous Application Made: Yes E] No R New Construcfion: Yes [4 No r-1 FHA/VA: Yes F1 No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or'cesspool permiffed if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well-----$_p---Distance from foun�ation----1-0--- Mfe,iaI_.rC__W1_44 <br /> Disposal Field: Distance from nearest well _t$.V1__.D'stance from founclafion-_-:11------ Distance to nearest lot line---J�------ <br /> SRUPZP19�- Distance fc, nearest well-----/go--------;-Distance from founclafiol-47k-1-------Distance to nearest lot line__X�� <br /> Cesspool: Distance from nearest well---------- <br /> I-i <br /> _-_-- _ ._-~. .of ..^----_-------.""-=-`=.___--------------..-� ----.----. °�^ <br /> ' Romocle�ing and/or� ^ repairing (describe):--''�''-'''-''�'''_'-'__.-___--__-___�___��__�___ ----------------------------------------------- <br /> -------------- <br /> ^ �_-_----''��-,''-'_--''�__'-_'-'---__.--�-----_-'''-_-'-~��'''--'-'''-^_'-_..-_--------_ <br /> -------------------------------------------------------------------------------------------------------------- -------------------------------------- <br /> ----------------------- ---------------------------- <br /> ------------ <br /> ' <br /> 1,hereby certify that I have prepared this application and that +he;'Work will be done in accordance with San Joaquin Cou My 10 <br /> ordinances, State laws, and rules and regulations of the Joaquin.Local Health District. <br /> , <br /> *11 <br /> (Plot plan, showing size of lot, location of system in.relafion to wells, buildings, etc.,--can be placed on�reverse side). <br /> FOR DEPARTMENT.USE ONLY <br /> APPLICATION ACCEPTED BY----iltwwk <br /> Alterations and/or recommendations:-------- --------------- <br /> -'-.--'''-'-_-''-----^----''''''-'--''''-''-----'---'-''--_--''�'''-_--''--_''__-''--'''---_--''---''- <br /> '---'_-_----_-_--------_------._'_----__-.-_------_--._-_-_-----.-'--'__-_' <br /> --'-'- ----------------------------------------------------------- -'---''''-''-''''--_'''--'''''--^''--''''---''--- <br /> ' <br /> FlNAL INSPECTION BY/--- -----_-- ^ Dv+a- � <br /> SAN JOAC2U|NLOCAL HEALTH DISTRICT' V <br /> \ <br /> mo sovm American Stmat 30D West Oak Street 132 Sycamore Street ow North ^C^ Street <br /> ' <br /> sto"k+" . California Lodi, California Manteca, California Tracy, California ' <br /> eo--17-2w . n°~/"�6 1.57 pRzo. <br />