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' <br />- FOR urmCc USE, A.OPOCATIONFOR SANITATION kRMIT Permit No. <br /> (Complete lmTriplicate) <br /> ^ Dom, Issued <br /> / ! h| iExpires I YFrom ����Um�ww� � /'S'-7_C_3 0 -_!5�0 <br /> n ' ~- <br /> Application is hereby made to <br /> the San Joaquin Local Health District for o 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 /> 14 ( ee------ ----------- -----------------------CENSUS TRACT -------------- ----------- <br /> JOB ADDRESS/L �TION'Palvj_ <br /> Phone <br /> Contractor's Name --------License <br /> installation will serve. Residence E<P-a-rtment'HO'G-s6,o-C6ryii-�-�r-ciaI rIT611le"r Court RE] <br /> 4Note F�Other -------------------------------------------- / <br /> ' �� ^ �- Lot Size /_�,�/� /� /�/e�/��Number of bedr6pm� -- <br /> / Water Supply; Public System and na e ------- <br /> r of Soil to a depth of 3 feet. l/ Clay Peat E]' Sandy Loam L]` Clay Loam Ej <br /> Hardpan LF� �Adobe, <br /> must be placed on reverse side.) <br /> JPIot plan, showing size of lot, lo�c�tion '�f system in relation o we 6 <br /> NEW INSTALLATION: (No septic tank or, seepage pit permitted if public sewer is available within 200 feet) <br /> -------------- <br /> PACKAGE TREATMENT SEPTIC TAN Bize---��t Liquid Depth -- -- ---7- <br /> 6_ _46VLt_ <br /> Ty <br /> Dis._.. Yto ne res <br /> d Y!��K N a C <br /> SEEPAGE PIT Depth Diameter Number --------�1�_ ------------ Rock Fille <br />� | ---istan . � ] � <br /> (Prev. on�oMonPmrm��� ---.—.—'-- uo,� '_--'--'---'-'_ <br /> m�r�o --'-�� | / <br /> ---�-'.-.—_.__-- <br /> Sep�cTonk (Specify Requirements) ---------.--..----.------.--.-_I ----------------------------- <br /> I <br /> ---_, ^ <br /> Diapooul Field (6pedfy Rnqui,oh�enY� -_-..-.--'-_-.---'-_-'`------''�-'------�--------_--' <br /> k - ' -�` [1 -'r----------------------------- <br /> - <br /> -- '-' Y <br /> / ,.-- _.---._ <br /> .-----'--_.----_.—_----',_�� �~ � <br /> ------'--r'---- 'r��.._-'' <br /> -,._.--_—.--.—.---�, <br />� ' --_-''---_--.—_ � <br /> --'---- <br /> i' (Draw existing � _^ hd—* <br /> I he'e6y «erHfylrhmt | have prepared this mppucmu�� and that the -~'~ will -- - - in accordance'~ with San <br /> Joaquin <br /> Y�mn^ <br /> Ordi nce� State Laws, no Rules onmmegula ."~ ° °. the San Joaquin Local -'- �t , H <br /> , <br />` <br /> sed agents monmtwre certifileohe following:"I certify ' the I rformance of the work for which this permit is issued, I shall notemploy any person in nm <br /> *� anmmm <br />� <br /> as to become subjictlto <br />, <br /> Signed .... <br />' XA / <br /> "' <br /> jif other than ow <br /> IV <br /> ,f OR I)EPARTMENT "USE ONLY <br /> APPLICATION ACCEPTED BY � <br /> � ---------------------- i <br /> ir`DD."O ,"` CO.,,~. _.'______.__________._ <br /> � �------ ~' -----------'-------'-- �| <br /> � --'�`- _. _-.. �� . <br /> ' ----�''��'-'-�---' '� -----------�Do�o ��'---�^ ^�~'— <br /> �no| |n,pechonby. '--'- '~-' <br /> SAN JOAQUIN LO/CAL HEALTH DISTRICT <br /> ' <br /> E. H. 9 1''68 Rev. 5M <br />