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FOR OFFICE USE: | "^"CATION FOR SANITATION PERMIT <br /> �� �"�� PennhNu <br /> --''-'- (Complete in Triplicate) <br /> «- DoIssued <br /> U � ���� '� �'^"^" ���r�xw ��t�U �� <br /> � <br /> . <br /> tothe Son Joaquin Local Heo|M, District 6m o � to con <br /> v�vc and install +�e work6e,ehm <br /> �r'^^~^~ ^~y^^~- is made in compUonce with County Ordinance No. 549 and existing Rules and Royo| <br /> /7 ,���x� i <br /> � °"".=^" <br /> � ` .� �� /��� �� # �''-- <br /> . ~ , _ <br /> ' hn�oUohonvNUoenx� ResidencaG� AporhnentHouse��1�ommo�|a| []T,oUerC*u� �� ~ <br /> ' '-' � � ' <br /> � <br /> ��ute| E]Other -_---.__--'__ ' � 1� <br /> Number of living units..---'-/---- 'of� bedrooms3'_ Grinder ^�/\� <br /> '�o,600� Grinder .. Lot Size — �-'- <br /> n ' <br /> Water Supply. 6| and Private <br /> 1i Clay Peat E] Sandy Loam Ej Clay,Loam <br /> Character of soil to a depth of 3 feet: Sand'E] Silt El <br /> | � <br /> (plot plan, showing size 'Of lot, location of-system-in relation 'to wells, buildings,_eic. must be placed on reverse s <br /> NEW INSTALLATION-- Ao septic tank or seepage pit permitted if public sewer is available within 200 feetl <br /> PACKAGE TREATMENT f.il <br /> � <br /> ; -------------------- <br /> LEACHING - - r~ al <br /> � '�'� &ox ��»-.� Typa Filter Material ..��' o6�.-'Deo+k FilterMaterial -. ��,-----_--��--' <br /> � � ----------- �- _`_~J ^ .. nearest: <br /> VeU ._ K�'--` Foundation �-1o9.r_-- Property Line -- <br /> —, <br /> -'1 <br /> SEEPAGE PIT ' -' ----- Diameter Number ---.|/�----. Rock R �6 ��u [] N^u, <br /> .-O- <br /> - <br /> vVo�e, Table Depth <br /> Rock Size ------`----. . ^ <br /> � �0 '' Distance to nearest. Well -------------------- -------------------- ----- -------------- Prop. Line --'--.'-_ <br /> � ^ " <br /> . (Pn,v. 3on�oMonPe,m�,� -_-------_--- Date ------_--'-> , <br /> Septic Tank (Specify <br /> ! Disposo| Requirements) --__._-___-'—.--''----------'----^---'---'''- <br /> --.-----' ........---------------------- ---------------------------------------------------------------------------------------------------------------- --_'-'-_. <br /> yy o <br /> |� ----- ------'��- — U�--- --------------'-_'—_---_----'------------ -------------------------------------* <br /> ------- <br /> (Draw existing <br /> -.(Dnzvwxi$im- and required addition on reverse side) <br /> ' <br /> ' I hereby'certify that | have' uned this application and Yh�v the work will be done in accordance with Son Joaquin <br /> County Ordinances, Stat Laws, and Rules and Regulations of the Son Joaquin Local Health District. Home owner or licen- <br /> sed agents signature certifies the following: <br /> ", certify that in the performance of `"= `~°`k for which this permit~ is ^~~~~~' ' shall— not employ any person in such manner � <br /> as o become s ct ork n's Compensation laws of California." <br /> ' <br /> By -�����_����----'—.�---�����_��—'—'-------������- TNm`-----------------''�--`--'- <br /> [ (|f othei than owner) � <br /> n <br /> � 1OR DEPARTMENT USE ONLYV7 _ -_7,; - I --- ----------- ------- <br /> ^ <br /> ` <br /> ` .--�----��—. _--'--.__-_.-'-----'- <br /> ' ----'-- --'---- <br /> -------'-'- -Dote �� �-7�� <br /> Rno| |napncton6y ��.��.- �����------'' -'^-_ ',-- -- <br /> `SAN J�]AQU|N LOCAL HEALTH DISTRICT <br /> ^ . _ <br /> ' <br /> E. H. n l''68 Rev. 5N\ - <br />