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r <br /> FOR OFFICE USE: <br /> APPLICATION FOR SANITATION PERMIT <br /> r <br /> ................... <br /> ........ Permit No. 7� -.�4 " <br /> cr,�9..... {Complete in Triplicate) <br /> ........... <br /> :r 7 <br /> ,,. Date Issued ./A.................. <br /> ....---------. . ...... I This Permit Expires 1 Year From Date Issued—_.---% <br /> Application is hereby made to;the San Joaquin Local Health District for a permit to construct and install the work herein <br /> described. This application,is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: <br /> k tP �I � /L � '� ' ' G7. Side of Cox appx. 500 yd. North of Baker <br /> JOB ADDRESS/LOCATION .:....: �.. CENSUS TRACT <br /> Owner's Name ._..Wade Loveday...............................`.-• ••-----•....--•-••-•-...,-----------••--- .-----.:..:.........Phone .�................ ................. <br /> 2842 Pinasco Stockton <br /> Address ---------- -....... •-----------•--i-------...._......................................---------------.... City ....................-----------............................................ <br /> Contractor's Name -------goto..Ro4ater---Seaer,._Sarvice...........................License # ....2.71539....... Phone .._4 ?5-26 6_ ........ <br /> Installation will serve: Residence ®Apartment House❑ Commercial ❑Trailer Court 0 <br /> ji <br /> Motel ❑Other :a_.:: , .a <br /> g ......................... ....•- <br /> Number of living units.-­A.. Number of bedrooms 3_.. `-_Garbage Grinder Xe5...... Lot Size ............_.... � <br /> Water Supply: Public System and name a ....Private <br /> Character of soil to a depth of 3 feet: Sand❑ Silt❑ -Clay ❑ Peat❑ Sandy Loam (3 Clay Loam <br /> I� Hardpan C] Adobe Fill Material .......... . If yes,type .......................... <br /> no <br /> (Plot plan, showing size of loll, location of..system in relation to wells, buildings, etc, must be placed, on reverse side.)~ <br /> NEW INSTALLATION: (Nonseptic tank or seepage pit permitted If public sewer is available within 200 feet,) . <br /> SEPTIC TANK fK3 <br /> ------- <br /> PACKAGE <br /> --PACKAGE TREATMENT _ Liquid De <br /> pth .. <br /> 4 <br /> ._. ............ <br /> 2Ca autYQ .........._ Type Pre--- Material-Goncre-t.e.... No. Compartments ....- ------ -- - - . <br /> Distance to nearest- Well ..... .............Foundation ----••-----.. Prop. Line� 71, 110 <br /> LEACHING LINENo.t of,Lines _ Length of each lme............................. Total len th .......... <br /> ..................... <br /> 'D' Bo"'Y. s....... Type Filter Material .rOc ..........Depth Filter. Material :..: 8��.._=• ........f­­. <br /> Dist . 5 <br /> ance-to-nearest:Well--.---�/ ---.-.--Foundation .-1Q................:• Property Line: .............---......... <br /> SEEPAGE PIT [ Depth !' 5:.....:.:...... Diameter •-.. ........ Number ----_.-----_-.----..--__ - Rock Filled Yes No. <br /> u � - . Ikt� by air ' <br /> Water Table, Depth . $ -•----••-•----..Rock Size ................................ ! <br /> I .._...Foundation ....101 Pro Line .--.:51 <br /> Distance to nearest: Well .---..:..11)S3'__•-------•.__-•- .... p. ....................... <br /> / 6 <br /> REPAIR ADDITION(Prev. Sanitation Permit# ..............••-------,_................... Date ....................:..............I <br /> Septic Tank {Specify Requirements}�,...°.�--••------------.....................•--......--•--....._..-----........_._...._.._:.----------------....-----•---- ---•----- <br /> Disposal Field {Specify Requirements) ...........................rt _- _- --- _--- <br /> .._..--•--••..................................I.:.....I....._--_...- •. •------••-•--•-•---._._._..._._._..............-•---........_..----•-............ ...... --....... <br /> •-------•...... ............ ............•--• --------- ... ............_....._..•..._ ............------.................................. <br /> 1 i! (Draw existing and required addition on reverse side) <br /> I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin <br /> County Ordinances, State 'Laws, and Rules and Regulations of the San Joaquin Local Health District. Home owner or licen- . <br /> sed agents signature certifies the following: x <br /> "I certify that in the performance of the work for which this permit is Issued, I shall not employ any person in such manner 1 <br /> as to become subiect to Workman's Compensation laws of California." i <br /> Signed ............ . ............ . ''..... ... ....................... Owner w <br /> By •................. . .... ... ... Title <br /> Contractor <br /> o er than owner <br /> . :� FOR D ARTMENT SE ONLY <br /> API�LICA,kIOA ACCEPTED BY..;..--...-- -� ............... .._. ......--...... ....... DATE ...=..... <br /> BL11lDIN rwRMIT ISSUED -------------------------- DATE ............ " <br /> ADDITIONAL COMMENTS ....... :..:...: ` <br /> •-•.........................................._.!..._`.: ....------•-------•--.-•--- r'-•--•-. ......................----•-- --- -••-------•- ---------.-----•- <br /> . ......... `. ........................•........ ......... <br /> ..................................... ��__"_ ........... ........ _... _ <br /> ... ........................................................... <br /> Final Inspection by, Dat <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT. <br /> E. H. 13 24 1.'68 Rev. 5M 7/72 3 M <br />