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FOR OFFICE USE: <br />-------------- <br /> ------------------------------------------- <br /> APPLICATION FOR SANITATION PERMIT Permit No. Z./--- ------- <br />---------- ------------------------- --- -------------- <br /> --------------------------------------- ---- -------- (Complete in-Duplicate).. 6, <br />--- ----------- ­--------------------------------- This Permit Expires I'Aoiir From Date Issued Date Issued <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> i - <br /> This application is made in compliance with County Ordinance No. 549. <br /> IE 7 <br /> JOB ADDRESS AND LOCATIOV T0­7N_(`F___f'3_1_1 --------a -- - - - --------------- -------- <br /> --------------------- P, <br /> Ye 7— <br /> Owner" Name----)Ivl�&A ej--- hoZ - `7 <br /> • --------------- <br /> -----------------------------------------------------............................ <br /> Addre" -------- ---- - ----- az <br /> V <br /> fit. r <br /> Phone..................---------....... <br /> Pa.__� ---- - -------------------------- <br /> Nameg2a___ 6z_ <br /> Installation will serve: Res;clenceo Apartment House ❑ Commer di ❑ Trailer Court [I otel ❑ Other E3 <br /> Number of living units; Number.of bedrooms Number of baths -------- Lot size ------M------ ------✓ .......... <br /> -------------- <br /> > <br /> Water Supply: Public system 0 Community system 0 Priva te-4 Depth To Water Table ZO_ ft. <br /> Character of soil to a depth of 3 feet: --Sand C] ' Gravel El Sand Loam Loam :Glaj Loam Clay Adobe[] Hardpan Et/ <br /> Previous Application Made. {If yes,date------e�--- - ---- <br /> - 7-- -- No--M- e&-Construcfion: Yes L) No 0- FHA/VA- Yes ❑ No El <br /> _Ie� - <br /> TYPE OF INSTALLATION AND SPECIFICATIONS; <br /> -(No septic tank or cesspool-permit te-&if-public sewer,is-available-within <br /> Septic Tank: Distance from nearest from foundafion-10--------------Material <br /> 4!_/ capal ity.. <br /> -tm'ents--------- 41 --------- <br /> No. of compaj --------Size_!IAX4, Liquid clep�h 4y <br /> Disposal Field: Distance from nearest well------6-0.16stance"from foundation____4?4�6tDisfance to nearest lob 0... <br /> ------- Length line-1 4>0-71 Width of trench__V��---____-- ..___________..... <br /> f of lines____r V---------- <br /> Type of filter material.-./YD-ia4e----DeptH'of filter material----/- ------------Total - _-__--_________ <br /> Seepage Pit: Distance to nearest well-/ Disfanc from founclafion-/0_..______.Distance to nearest lot <br /> To, <br /> C, Number of pits------/--------------Lining. material_y�.Z<----Size: Diameter _--!r -------_.De pth__/e--—--------------- <br /> 461------------------------------------- <br /> ,--��cesspooi: Distance from nearest well____A�Z-----Di`�sttince from foundation--.- mate - <br /> Irl Size: Diameter-- <br /> ----------- --------------------Depth--------- ------------------------------------.-_--_-Liquid Capacity----------------_----------gals. <br /> Privy: Distance from nearest well----------1----------------------- _-._.._Distance from neares,t'6uilding------------------------------------------ <br /> ❑ Distance to nearest lot line------------------------------------------------------------ - , <br /> ------------------------------------- -------------------------------- <br /> Remodeling and/or repairing (describe):---- ----------------------------------•---•-------• <br /> ----------­................----------------------1-------------------------------------------------- ---------------------------------------- I-------------------------*------------- <br /> ------------------------------------­­---------------------------------------------------------.......I---------------------------------- --------------------------------------------- -------------------- <br /> ­ - . - I I . , ---- <br /> ----------------------------------- ---------------- -------_-------- -------___75----------------------------------------------------- ------------------------------------- <br /> ---------------------------1-1-------- <br /> I hereby certify,fll�pf 11.'have prepared this�applica�ion and that�,the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and-'rules and regulations of.f.b_e San Joaquin Local Health District. <br /> 0....... ... -- ------ and/or, <br /> (Signed),----0- ...... -----_---(Owner -on poctorl <br /> iy:---------1- Tith -------:._--•---------------- <br /> r _­------------- ------------------------- <br /> c torr- <br /> (Plot plan, showing size of lot, location of system in re ion to W ells,''buildings, etc., can be place on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATIONACCEPTED R,0------------ ----------------------------------------------------------- DATE------- ----------- <br /> REVIEWEDBY--------------------------------------------- ------------------------------------------------------------•-•-• ------------ DATE------------------------------------------------------------ <br /> BUILDINGPERMIT ISSUED----------------------------------------------------- ----------------------------------------------- DATE------------------ ------------------------------------------ <br /> ?Alterations and/or recommendations:-.------------- ----------------------------------------------------- ----- - ------­-------------------------------------------- <br /> i P ------•----------------- <br /> ---------- >< <br /> ------------------I---------------- .....API-A-------TZV-------- -------­----------- - --_-------------- --- --------------------- <br /> -0.1: <br /> I.................................­-------------------- ----------------------------------------------- --------------_------ -------------­_ --- <br /> 13��_FO_KF <br /> R. <br /> --------------I------11--------------- --------- ------ - ------ ... ........... .. I----- -- ----- ------------------1------------------------------------------- ----------I.................. <br /> FINAL INSPEC I --- ---- ---- ----- Date_,�----------- ------------------------------------ <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street 124 Sycamore Street 20S West 9th Street <br /> Stockton,Calif locil,California Manteca,California Tracy,California <br /> ES 9 REVISED 8-59 2M 5-62 ATLAS <br />