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' <br />APPLICATION FOR SANITATION PERMIT <br />(Complete in Duplicate) <br />Permit No. <br />n^_ /_-, / /a.ry <br />-r i <br />' <br />°�." .===u <br />gplicafion b hereby made to the San Joaquin Local Health D�fhctfor u pnnn�+ocono�ucfand i��|�� � 6 � <br />|hi, <br />application |smade in compliance ifhCounty [)rdi n work n <br />------------------------------- <br />Contractor's Name <br />Installation will serve: Residence House Commercial El Trailer� Court E] Motel E] Other 171 <br />Nurnber of living units, Number of bedrooms Z t s <br />Water Supply: Public system Community system Ej Private 21"Depth i r - <br />Character of soil to a depth'�f 3 feet: Sand 0 Gravel 0 ' Sandy Loam ��Cjay Loam E] Clay 0 Adobe Hardpan Ej <br />Previous Application Made: Yes [] No New Construction: Yes 0 No E] FHA I /VA: Yes F-1 No M <br />TYPE OF INSTALLATION AND SPECIFICATIONS: <br />(No septic tank <br />ool <br />d if <br />r is available within 200 feet.) <br />.=- Sepk=r_ - 01 ' <br />Is aric stance <br />----------------- <br />Disposal Field: Dis�ance from rearest'well ---- Y'� -------- Distance from foundafion_/j0__-*-_�__istance to neares'06� <br />��-Depfh of filter material ---- ------- Total length ----- <br />Type of filter material -_-A <br />4 ------------- * ------------ <br />------------ <br />--------------------------------------------------------------------------------------- <br />---------------------------------------------- <br />--------------- <br />I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br />ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br />��n�� ���-*��"� v�'� <br />.. - _------------------------(Ownoran6/w, Con+racforj <br />py�____-_-_----_-___------�-'_-__---_--_-.- <br />-�-^�k�p�n ^yvt,m�v��*fonfp-~eUo�6uUJ�gs'wh:,''`�--''''--�'''-------'-'-''--'�FOR DE�PARTMENT USE ONLY, <br />APPLICATION ACCEPTEDBY'-� <br />REV|EWBD BY ' - - -'- - ...... <br />-------------____________________'_'''_-.'- - <br />8U|LD|N{�PER��|T|SSUED._-_-_-_'_--�----_-_.---__-_--'-_- DATE <br />/ � <br />n.6a./'tions: --''---'�'--''_-'-''''-_.'-_-�-_' _----_�- <br />��-/---__'_- <br />�' <br />-'-- <br />----`''---'_'---- <br />'------'-_- <br />'.______.-________.`____________-________.__..__________��__ <br />.__----__.-_-----_-._-----__----_---._-._--.---.--___-_-_--_._-_-'___----' <br />__----'_-_'--'-_-''--'-_-''-�''-'--�''_------_---'''-''�'--'''--''_-.---'--'__.''-- <br />----_-.--._---_------_-..''^ _.-'_-._---.. ''--.'----. <br />RNAL INSPECTION _,.=�_.^-~_.__-_�..'_ Date ------ ' /- l'--''----'-' <br />S/NJOAQ0NLOCALHEALTHD|STR|CT <br />/�S���S� ���s� /����s� m4N�C'�� <br />s�"*" California u�� California Mw"� California Tracy. California <br />' <br />ES -9-2M u°.is°* /.57 F.poz <br />