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FOR OFFICE USE: <br /> APPLICATION FOR SANITATION PERMIT Permit No. A <br /> --- -------------- - <br /> ------------------------------------ - --------------- (Complete in Duplicate) p <br /> ------- -------- This Permit Expires 1 Year From Date Issued Date Issued ._'7_--_� _ �� <br /> Application is hereby made to the San Joaquin Local Health District for a permit to constru t a�1d install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. A ell -, 02S—LZ--3b <br /> r J <br /> �V( nJ. zDE ✓4c ,P-s 4-,j - First house North of Sergent Rd, on west side of Devries Rd. Lodi <br /> BADDRESS AND LOCATION-------------------------------------------------------------------------------------------------------------------------------- ---------------------•------------ <br /> Frank Aberle - <br /> Owner's Name-------- - - --•---------------•----------------------------------------------------------------------------------------------------- Phone--369.2502---------•----- <br /> Address-------------------Route---Z1. _Rox_J4.02a---Lodi-------------------------------------------------------------------------------------------------..-------------------------------•----- <br /> Contractor's Name_-S iekgrman-Cc�ncre�. T Co. c/o Dick Schamber 369 3596 <br /> P ---- -------------------- -----------•---------------- Phone...- -•--�---------.... <br /> Installation will serve: Residence `2 Apartment House ❑ Commercial ❑ Trailer Court E❑ Motel ❑ Other ❑ <br /> Number of living units: _{----- Number of bedrooms 2-.____ Number of baths _1__._ Lot size ____25-.AC_.__________________________________________ <br /> Water Supply: Public system ❑ Community system ❑ Private:] Depth to Water Table A�- ft.- <br /> Character <br /> t:Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam7© Clay Loam ❑ Clay ❑ Adobe ❑ Hardpan ❑ } <br /> Previous Application Made:T(If yes;date_.__Nq..'.._-.._}'No ❑ 'New Construction Yes E—No-�— FHA/VA;..Yes ❑ No ❑t�� ,, <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well-----' .0..ftDistance from foundation-------10ft---Material__.________________________________ <br /> RNo. of compartments-------2-----------------Size--------------------------------Liquid depth---------------- ---------Capacity-----8QQ---Ula. <br /> Disposal Field: Distance from nearest well------tF_®-__Distance from foundatio _ ____ D_______-Distance to neares�Jol line___S____i ____ <br /> 14j- <br /> IR Number of lines-----------2----------------------Length of each line-_-- - 0 F ' Width of french-------__._n'------------------- <br /> Type of filter material +___�ek_.__Depth of filter material___ '----In'-----Total length---------------260__Et-----___---- <br /> Seepage Pit: Distance to nearest well----------------------Distance from foundation--------------------Distance to nearest lot line_____.__-_____.__ <br /> ❑ Number of pits----------------------Lining material-----------------------Size: Diameter.......................Depth-----------.--------------------- <br /> Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material_____________________________________ <br /> ❑ Size: Diameter- ----------------------Depth----------------------------------------- ----------Liquid Capacity. .....--------------------gals. <br /> Privy: Distance from nearest well------- -------------------------Distance from nearest building----------------------------------------� <br /> ❑ Distance to nearest lot line--.-- .--------------------------------------------------------------------------------------------------------------------------------------- <br /> Remodeling and/or repairing (.describe):--- -------- ------------------ ---••------------------------------------:---------- --•---------------------------------------------------- `\ <br /> -----------------=------------------------------------------------------------------------- ------------------------------------------------------------------------- ------- -------------------------------------------- <br /> -----------------------------------------------------------------------------••------------------------------------------------------------------------------------------------------------------------------------------- <br /> --------- -- ---------------------------------------------------------- ---------------------------------•-------------------------------------------------------------------------- --------r--------- <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 s a d rules an egulations of the San Joaquin Local Health.District. <br /> -(Signed <br /> -- -----------------------'------=-�,.--=-----------------``-'-----------------------------:::------:-(Owner-and or Contract l <br /> By:--- P, uller---------------------------------------------------------------------------------------------------(Title)Business__Nanager_----- --------------- <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED 8Y_ __.__._ <br /> . 1�' -- DATE- h <br /> - <br /> REVIEWEDBY------------------------ ---- - ------------------ ----------------------------------------- ------------------------------ DATE-------- ---------------------------------------------.---- <br /> BUILDINGPERMIT ISSUED--------------------------------------------------------------------------------------------- ------- DATE------ ----------------------- ------- -------------- <br /> Alterationsand/or recommendations------------- ------------------------------- ----------------------------------------------------------------------------------------------------------------- <br /> ------------------------------------------------------------ -------------- ---------------------- ------------------------------------•--------------------•------------------------------------------------------ <br /> i <br /> -----•---------------------------------- --- ------------ ------------------ - ----- ------------------ -------- ------------- --------------------------- --------------------- ------------------------------- <br /> 1 rti <br /> -------------------•--------------------------------------- ------------------------- ------------_................... ---------------- -- - ----------- ------------- <br /> FINAL INSPECTION BY ______ �ff---------------- Date- - -----_-__-- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E.hlazellon Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th street <br /> Stockton,California Lodi,California Manteca,California Tracy, California <br /> F.P.0 O. <br />