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Permit No. <br /> APPLICATION FOP, SANITATION Il <br /> PERMIT Date issued <br /> (Cofnpiete in Duplicate} , issued <br /> E year From Date 11 the work herein described. <br /> This Fiel"I'lil construe and insta <br /> San Joaquin Local Heallb District for a permit to cons <br /> Application is hereby made to the S with County Ordinance No, 549. -------- <br /> This application is made in compliance --- ---------------- <br /> This <br /> ADDRESS AND LOCA-fION----,3+5------ ----------------------------------------------- phone-:W@-------- .. . . <br /> --------------------------------- -------------------------­---- <br /> Owner's Name----------- Cj.........0-47 ------------------------------------------------------ <br /> 11. <br /> ----------- <br /> -------------------------------------- Phon <br /> ----- ------------------------- ------------ <br /> Address----------------------1�f--------------- -------- Motel El Ot6er V�­/ <br /> Contractor's Name Apartment House 0 <br /> Commercial 0 Trailer Court 0 -�-------------7---:S------------- <br /> size ---- <br /> ion will serve, Residence 0 <br /> Installation units: -�-- - rooms --�.. Number of baths --'k' Lot <br /> Number of livingNumber of bed Depth to Water Table J'lXft, <br /> 14 Commun�ity system C] Private ❑0 Dep Adobe 0---H/ardpan [I <br /> Water Supply. Public system feet: Sand El Gravel 0 Sandy Loam [] Clay Loam D Clay 0 o <br /> Character of soil to a depth of 3 1 New Construction: Yes 0 No W-,��A/VA: Yes [] N <br /> Previous Application Made* Yes ;��: <br /> TYPE OF INSTALLATION AND SPECIFICATIONS' s available within 200 feet.) <br /> [No septic tank or cesspool permitted if public sewer i ce from foundation______-- Material------------------------- ----------------------- <br /> Distance from nearest well-----------------D.1 i-stanLiquid dep.th----------------- --------Capacity_.----- <br /> -------Capacity-------------- <br /> pfic T nk: -----------------Size-------•- c, <br /> No. of compartments--------- / ��­-.Distance to nearest lot line-----A-------- <br /> ce from foundation--- �!----------------- <br /> Distance from nearest well__ <br /> Distance ie-- ­1-------------- dth of trench <br /> isposal Field'. ------Length of each line <br /> Number of lines-­-I.......I---------lk erial ...­/--g­'�------Total length------ -------- ---------------- <br /> ----_pe pth of filter mat <br /> Type of filter mater -1 <br /> 4­ R IS Dista nce to nearest lot line <br /> -yjAe Distance from foundation Depfb-..._4-- f—Y�ADistance to nearest weILN Size: Diameter-- 4 <br /> t Lining material _ ------- material ------------- <br /> . '-.A * ing ---------------- <br /> Number of Pits-­/--------------- -------Ci n <br /> XX`+ from foundation- -------- <br /> 1+ AZ -------- .....Liquid Capacity_.__-----------"----------gals.. <br /> Cesspth <br /> ❑ool Distance from nearest well w <br /> sj7Diameter__ __' <br /> e: --------------------------- Distance from nearest building_--"--------------------------------- <br /> -------------------- <br /> Privy: Distance from nearest well------------------------------------------- --------------------------- ------------------------------------------------- <br /> Distance to nearest lot line_______-.._-"-------------------------------- <br /> ❑ <br /> a�ring (describe):---- ------ ---- -::sf------------------------------------------- <br /> and/F�o, ---------*-------IF__,-- --------- ---- ---------------- <br /> Remodeling and, or -- -------- �t <br /> ------------ <br /> ---------------------- ------ ------- <br /> ---------- --------- <br /> -------------- -------------- ----------------------------------------------------- <br /> ... .. ... <br /> ---- ------- ---- -- ----------------- <br /> --------------- ------- -------- quin County <br /> ...... ....... h plication and that th work will be done in accordance with San Joa <br /> -------------- <br /> 6 cert, y <br /> I hereb certify th 1I aye prepared this of San Joaquin Local-Health District. <br /> ordinances, State laws, and rules and regulatio (Z' _[0 <br /> (Signed]----------------- WContracfor) <br /> I ----------- <br /> _lj�& .T,---- -A--------------------(Tit-1-e-)------------------------------------------------- ------------ ------- <br /> ----------------------- ---------- reverse side). <br /> -------------------------------------------------------- can <br /> i s, etc., be placed on <br /> By:------- 11 bu-,14 <br /> 0 ow I S. <br /> (Plot plan, showing size of lot, location of system in relatio 0 w <br /> DEPARTMENTFOR USE ONLY <br /> DATE------- <br /> APPLICATION ACCEPTED B .. ....... --- <br /> 1-4-1 DATE_______ -v­e­�1.1 <br /> REVIEWEDBy------------------------------ ------------------------- DATE---------------------------------------------- ------------- <br /> BUILDING PERMIT ISSUED--------------- --------------------------------------------------------•-- <br /> ---------------------------------------------------------- <br /> - ----------- ---- -- - ------- - *- <br /> - -------- ---- <br /> ---------- ----- <br /> ----------j7�-----------/---�--4--0--0--1-6----0-1---- 0------------------- ----------------- ----- - -------------- --------------------- <br /> ---------- --------.- <br /> --- ------------------------Alterati5sand/or recommendations:----- ---&-- ----------------- --- ----- ----- - <br /> --- ----"- <br /> - <br /> .......------- <br /> - ------ <br /> - ------------------------- ---------- - <br /> ---------------------- <br /> ------ -------........ <br /> -----------------­��------------------------ -- --- <br /> ------ 61---- <br /> ------- ---- --- ------------ ------- <br /> FIN^L INSPECTION BY:----------------------------­­­----------------------------- <br /> i SAN JOAQUIN LOCAL HEALTH DISTRICT 814 North "C" Street <br /> 130 South American Street 300 West Oak Street 132 Sycamore Street <br /> Tracy, California <br /> Manteca, California <br /> Stockton, California Lodi, California <br /> E5.9--2M . Revised 6-'59 F.P.CD, <br />