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P-�(CATION FOR SANITATION P"ERMIT Permit No��f------3--- <br /> _e , , - /-//J <br /> L) - (Complete in Duplicate) Date Issued 0 Z L- <br /> Application is hereby made to the San Joaquin Local Health District for a perm�f to construct and install the work herein described. <br /> This application is made in compliance with County Orclinan�ce N79. <br />� <br /> Installation will serve: Residence Apartment House [-] Commercial [] Trailer Court [-] Motel E] Other E] <br /> .,""."=, of living units: <br /> Water Supplypublic system Private E] Depth to Water Tab] ft <br /> Character of soil to a depth of 3 feet: Sand Gravel El Sandy Loam [] Clay Loom E] Clay E] AdHordpan E] <br /> Previous Application Mm6n; Yes E]OF <br /> New Construction: -� No 0'��� �� <br /> TYPE � INSTALLATIONAND SPECIFICATIONS: ' <br /> (No septic tank or nwompww| permitted if public sewer <br /> � Tank: �i,+unco from neun,u --D�y+n ^�� <br /> No. ofcompartments'z�. _----.-Siza��..�4���.. ]Liquid 6ap>h��.' .--.Cmpoci+y.-' <br /> Dispuso| Field: Distance from nearest well------------------ from foundation--------------------Distance to nearest lot line-----.- <br /> [� Nvm6o, of lines-----------------------------------Length of each line------------------------------ oftrench--__---._-'_ <br /> Type of filter material-------------------------Depth of Shor material----------------------Total length'-_.--._--___.-__ <br /> "� � � <br /> 3 Pit� D�sfnn�a +o n�ures+ n|���*m�ct��_ tion °�� Di�+oncpfo neon, ~ <br /> - �' - � --�--- � ----- � '' ' ��'~~-'-- K�� <br /> ,�] Num6nrofpifn-..,^-_--.�ning m �� Dio��+;, ��'----Dopth.. �°�-..__.-_-- v^ ^ <br /> ~ ~ " - t/ ^ -� - - �~- �� <br /> Cesspool: Distance from nearestweU_----..D|d�:c� from foun6ot�m-������--_-�ning mufehuL.-_-__---__-_ ��� <br /> 0 Size: Diameter'--'---'---''--'�Dnn+h-''�''-'''''-''''---''--.LiovkJ Capacity----------------------------gals. <br />' Privy: Distance from nearest well-------------- ---------------------------------Distance from nearest building--__-__._-' <br /> ElDistance *onearest ]of line`''—' --._-'--'-_-______-'''__'________ <br /> Rvmodo1ing and/or repairing (describe):---'---' -__.___._-_____--'__._.--'___.----.--____-' <br /> '--'-''-----''----------------'------'---'---'----''--'----'---'-------'—�-------- <br /> '--'-------'---' ------'---'--------''--------'''--'-------------------'--'' <br />. '----___-.---__--.___'—_'-_---__-____---_-____-.__-__.-----_-_--____-_-._______._.. <br /> � | hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, SfTra,4, and �r�j a egulations of the San Joaquin Local Health District. <br /> ' (S'g"=n}-' -(Ownand/or <br /> (Plot plan, showing size o oca lion lo s em'in relation to wells, buildings, efc., can be po aced on reverse eii, <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BYQ <br /> ----------------------------------------------------------- <br /> BUILDING PERMIT ISSUED--------------j <br /> lei <br /> FIN/\L INSPECTION BY:----------- ^�" -_-__--_' Do��--.�../ � _--._-_.--_-' <br /> . / . <br /> � SAN JOAQU|N LOCAL HEALTH DISTRICT � <br /> /m s""m *m=ica" a=.* 30D West Oak Street oz Sycamore s*re.w m+ North 'zr' s*°° ' <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> Es-9-2w 8'5/ n^./"v6 vv',/uo <br /> . � � <br />