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- . <br /> FOR OFFICE uwE=-4- APPLICATION FOR SANITATION PERMIT <br /> Permit Nu <br /> ------------------------------------ <br /> (Complete lnTriplicate) <br /> J/ <br /> Dmte |syoe6 //��.��~ � <br /> This Permit Year From Date Issued <br /> ----------------- -- -------_-_ ~ <br /> o�uc and |n�pU the work herein <br /> tion is hereby made to the San Joaquin Local Health t� permit td . <br /> described. This application is made in compliance with County ordinance No. 549 ar�d existing Rules a <br /> JOB <br /> _~ ~~~ —/- '— x—'��' � ~. �m� <br /> ---' <br /> Ovne/s Name . city ^ 69,_~ ^=°-------------------- <br /> . <br /> ._�-�---_'�-'-�'_ <br /> Installation will 'serve., Residence n<P_C_1`rtment House f-l Gornryiercial�E]Trailer Court [I <br /> _-_- - ��.-- <br /> Number of living units:---- ------ Number of bedrooms -__15----Garba-g'e Grinder NO----- Lot Size --- <br /> am 210*"'Clay,Loam El <br /> �—_— <br /> ,m� <br /> Peat El Sancl� Lo <br /> ' . ` <br /> +~ � Hdrdpan � <br /> be placed on- reverse <br /> s, etc. must <br /> r~. showing siz_ of . location of system ~ <br /> v`" septic" tank o' seepage pit permitted `f public sewer is available <br /> NEW <br /> � <br /> � b Liquid <br /> Depth ----------­------ <br /> -~-'- <br /> ENT SEPTIC TANK Size <br /> Copodty --- Type __--- /_------ - No. ~° "p" "'^ ^~ ' ' <br /> Prop. Uno _'__-_'-_-' <br /> 1 Distance to nearest: Ve`| ' '' --Fuun6o�om ---------------------- <br /> f <br /> - ---__' <br /> f ��'6 line ' '� ' Tot� Length ---------------------------- <br /> LEACHING <br /> --'-_---'--- <br /> iEACH|NGUNE \ No. of Lines ------------------------ Length o <br /> �4 <br /> ~ <br /> ! ( 'D' Box --.. Filter Material .-- ------------Depth Filter Material ------------- ~-.�.-_--'.---'. <br /> o nn »x � ~ - �~°"� <br /> omion ' `, '—'' Property L�* ------------ <br /> Distance <br /> - <br /> Dimance + --- Rock Filled - Yes __ <br /> SEEPAGE PIT Depth -------------------- Diameter . . Numbe- � ^..^ <br /> Voter <br /> _ <br /> � <br /> Table Depth ---.-._---_-- -.-�oc� uw= -`~-.------_- _ <br /> ^ Db�/nco �onaon�t Well --_--.—._ �,---_--. Prop. Une _-------'' <br />� ~` \ / ' 8 <br />� <br /> ~'^r~~~' ' ' � <br /> / �� � <br /> - <br /> ------------------------------------------------------------------------------------------- <br /> uired <br /> --' -- (Drawexisting __ r_` a <br /> dditibr accordance with Son Joaquin <br /> / hereby certify that J have prepared this application and that the work will be done in <br />^ - <br /> C6urvty ora <br /> . <br /> sed agents~g. <br /> ploy an person in suith-manner <br /> rmit is issued, I shall not em <br /> .. _ / «.ernnx_t"a, ' <br /> as to beco e blect',to Workman's scition laws of California." <br /> Owner <br /> FOR DEPARTMENT USE ^»roLv <br /> APPLICATION ACCEPTED BY ---- ---I <br /> � '-- --- <br /> -��� __-__'__- ----------- <br /> -- <br /> -' <br /> .-----.- », --_-� . ' '��-' .'��=�'-..--- <br /> , -----------.---.. -- � ���� <br /> '-- - '--Do�. -��-''���' ----- <br /> �no| |n .^^._^_u��4*�=`^_^_�_�___.�-_______._ � <br /> ----- <br /> SAN JOAQU|N LOCAL HEALTH DISTRICT <br /> ^. <br /> ^ � <br /> � ~ <br /> ` <br /> ' E. H. 9 l''68Rev. 5N\ * . <br />