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FOR(&Fi,,,y ASE. 77' <br />------------------------------------------------------ <br />------­---------------------- ----------------- —APPLICATION FOR SANITATION PERMIT Permit No. ___-L................ <br />------------------------------------------------------I--- (Complete "NDuplica <br /> Date issued �6 <br /> Is in -to) I I �.___ ___........ ---- --------- --------------- --- This Permit Expires'I Year From Date Issued <br /> ApplicatOn is hereby 'Made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This applica"tion is maclarin compliance with County Ordinance No. 549., <br /> JOB ADDRESS AND LOCATION...B.to....3#----B0.X__I92.7A,9---L-ad.4---Callf..L------------- .......... <br /> i..................---------------------- <br /> Owner's Nam,e__Juliamand..lalma.-He -er--------------------------------- .......... -------- -------------- P h6 4.' L4—:74724...Off -W <br /> ......Qf.Arm;u4.r_Qz;g <br /> Contractor's Name... -------------------------------------------------- Phon\eS k3-3955 <br /> .......................... <br /> .81 <br /> ence Apartment House E] Commercial [j Trailer <br /> Installation will serve: Resid' Court El Motel []',Other 0 <br /> Number of iiving'units:-__2---- Number of bedrooms ..3... Number of baths ..It Lot size .............. <br /> Water Supply: P0blid system [-I Community system E] Private [X Depth to Water Table ........ ft. <br /> Character of soil to a depth of13 feet: Sand F] Gravel E] Sandy Loam 0 Clay Loam K] Clay [] Adobe❑ Hardpan C] <br /> Previous Application..Made: (if yes,date-------------------- No 0 New Construction: Yes D; No El FHA/VA: Yes 0 'NoXI <br /> TYPE OF INSTALLATION"AND.SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sew.or is available within 200 feet.}- <br /> Septic Tank: Distance"f"rorn 'nearest well----50 Jr__-_.Distance from foundation....It?-- ---- Material------ <br /> ................. <br /> 4;lx Nok\of compartments....2----------1-------Sizet0x_6_1-----------------Liquid ....t.0 tal <br /> Disposal Field: Distance from nearest well....0_1----Distance from foundation.... .:..._....Distance to nearest lot line.'.` ,t <br /> -7effx Number of lines--4----1------ I--------Length of each line_____1004r J ........ <br /> ------- ----------------- ------------------------_-Width of french ------- <br /> Type of filter material-___--ra;z -------Depth of filter material-1O n_-1i--------Total length_______________-.!Q----------------------- <br /> Seepage Pit: Distance to nearest well_._1_00�--------Distance from foundation----101.......Dioance to neared lot lineff!. <br /> JOX Numbest of pits----._..� x....•....--Lining` material-----rack------.Size: DLam'7er......j6P <br /> et ---- Dept} <br /> Distanc8 from nearest . <br /> well----------------Distance from foundation--- -------Lining materiat...................... ------------- <br /> 0 Size: Diameter---k ...........------- --------Depth--------------------- ----------------------------Liquid Capacity.--------------------� _.gals. <br /> Privy- Distance from nearest well-------- ---------------------------------------Distance from. nearest buildA-------_-------❑ ----------................ <br /> g <br /> Distance to' nearest lot line--------Is------------------------------------- --------- -- ---------------------/ <br /> - ------------------- -- --------------------- <br /> and/or repairing (describe):-------Alow--isuste-M _Q par I......bQwjg...../-­----------­--------­---- ----------- <br /> .........................-_-------------------------`-----------------1--•------- -------------------------------- <br /> ----------------------------------------------------------------------- <br /> ------------------------------ ............................................ --- ------------------------------------ -------------------------------------------------------------------- <br /> 11 Arf W <br /> --------------------------------------------------------------------------------- ----------------------------------I---------Z---------- <br /> ---------------------------------------------------- <br /> I hereby certify that I have p�,epared thisi application--awd-th-a-f-th6-w6fk will 1be' ddn:"e in-a-c-c6-rdiri­c6­w_1th San Joaquin County <br /> ordinances. State laws, and rules and d regulations of f6 San Joaquin Local Heal -District <br /> (Signed)......11 .x.r4---SOP-t 10--- Xhc <br /> I - - - ----- ----------------------------------------m-------...... .........(OvAer and/or Contractor) <br /> (Tiff _G_e <br /> By:..........Terry---Nra rtA47;................\ ...... <br /> ----------------------------- ....... a .- _A?q_?t9------------------------------------ <br /> (Plot plan, showing size of lot, location I of system in rela4iori-to-welfs,*buildiniSi sett.,can be placed do reverie side). <br /> FOk'D;EPARTMENT USE-ONLY <br /> APPLICATION ACCEPTED BY---------------- <br /> -------------------------------------------. DATE------------/19. <br /> REVIEWED BY I t i --------------- <br /> ------- ---------------------------------------------------- <br /> ------------------------------------------------ _DATE----------------•-- -------------------- <br /> ------------------ <br /> BUILDING PERMIT ISSUED------------------------- .................. •----------------- ---- DATE------•------------------------------------- <br /> ----- -------- ---------------- <br /> r. <br /> Alterations and/or recommendations:---------- -------------------- -.1 / A <br /> ------------------wl�--------------------------­_­-----------*-------------------­----*----------------------- <br /> -------------------------------------------------------------------- , jo - <br /> ------------------------------------11---------------------------------1............................................................... <br /> ---------------------------------------------------------------------------------------------------------------- <br /> ---------------------------•----•--------•---••------------------------------------ <br /> -----------------------------------------­------------------------------------------------------- ­1--------------- K...... ----------------------------------------------------------------- -----------_------------- <br /> -------------­---------I.............. ----------------------------- ------- -------------------------------- ------------------------------------------------------------------------------------------ <br /> J, <br /> FINAL INSPECTIONpI XA/-------------------I-------- ............------------------------------------------------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Simet 124 Sycamore Street 205 West 9th Street <br /> Stockton,California Lodi,California Manteca,California TrOcYr California <br /> ES 9 REVISED 8-59 YM 5-61 ATLAS F <br /> A4 <br />