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<br /> APPLICATION FOR PERMIT
<br /> SAN JOAQUIN LOCAL HEALTH DIS'N C,
<br /> ;E.:II E. HAZELTON A',E., STCCKTO:f. CA
<br /> �J TE'tFhar.e 12i:1 -r6 67S1
<br /> FESMIT EXPIRES 1 YEAR FROM DAT_i rf•':C I ,i'.i� iy...
<br /> `,sir`,.... Il C riE'8 i 1 lair
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<br /> TYFE CF %.'ELL Pur P: E;v1._LL ❑
<br /> INSTALL,.104 ❑ SYr`E'•S F; FA:R G
<br /> DiSTA!:C5 .D!•V.nEST: SEP
<br /> TIC TA!:� cEl':ER Lt':ES :L \(:L — D1S?C£AL FL,-,.—
<br /> FC,C?. LINE
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<br /> _ i']P+r ':e 1-1 GINI n Dela De;:h cf Gi.ut stat — r
<br /> 1 1 1„i, Fon _ p6 m Ctp:'1 I 1 ea=tern Su fate as Ir.•.aCtd ty
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<br /> ;- �!!,'ur..SEr cf lninr,ur.;:s: !:Lrntei cf th'. ns -
<br /> : Ch.,rae:cr of icil io a Ce;:h e:3'fret: I:raier:�.`.:e depth —
<br /> SEPTIC TANK 0 T�;e,!'fg _� ___It: y_ !;a.Cem;trr-fess. _
<br /> I" PKG, TREATL'.E!:T PLT.❑ cf C?Ipt!al"
<br /> D;stance:o r•eklw: Frrptr.y Eine 11
<br /> t-r+ LEAC s Trialitnr,;his:e �i {
<br /> I:it.G Li::E ❑ !:a.6 LenSthtf'EnE
<br /> Fre tr. Lire
<br /> FILTER EED LJ [Y•a:ante Io rtalEtl; Y:eri Fcc:.dt:Scn F Y
<br /> SEEP-CE NTS
<br /> SEIRSFS L1 C:.,iancf to r tarett; V.'E'I_ Fov'•da;icn^ Plcptry Lire —
<br /> '- CISPOSAL FG':DS ❑
<br /> and
<br /> I hesety c:n,!y.hat i h.re prepared ih's eppl;ca :;on aad lh.t.t.e I+}c'k,,, Le dcr.e;n eccoidance w;;h San icaG'-in cour.:y e+Cinances,sate ta>~s,
<br /> !` rues and rt;,v'at:orfs of the stn Jcagv:n Local F'eel;h D ltr;ct. L` erml Ss;slued,1 sail net
<br /> l:ctrted agent's!;Gra:use cer;Ves;he!eI'er.;r�;"I cer..`.y. t;n;he per'ctmance of the s+a:k fcr v:h'ch this G Eed s:
<br /> '•'1 empicy any pvicn;n Such manner as to bttom6 Irb0cl:a+•.ca.rsaa's eem;tr.ta:kn faro c}Caii:crnia."Contrec;er's h;unp er su9 cerarr Q sr..ttvre
<br /> crri!its ihr tcec.v;n j: 'I crr;;fy:hat;n-he Ft�ermanct 0the r.r,k for,+hlch;h's perm;t;S:Mtd,I shall rmpley ycls+rs s�t;eet so l,erEmacisceagtraa• ,
<br /> ;Son la•as cf Ce!:fr
<br /> The applicac/t/rrt[Jl r i �'i:ed in: ec;:cr.r.CGmp't:e re,erye
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<br /> r � FOR DEPARTMENT USE ONLY � r
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<br /> :k :65E:E1 Cl Lctii ,3."fll 0 VLr,ttta &:3.710 q Titcy
<br /> ,�r••p,^.:;cant- Reicin a'I tcp'es:o: Erv:'rr,rT.tr.4I 1'tt:;h Ptim'itScr.%ts :fatfree 2C.)). -,.k, CA 55701 _ .
<br /> IEE - FICfnINEY CI•:E FIF�t,i'r.0. -
<br /> R'rGL':7 Cl'f F:•C '.T fE'••i�f CiF'CH �.._
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<br /> THE
<br /> 4 BION ,OF 1�S
<br /> DOGUMENr mwr
<br /> THE
<br /> IMLIROVED
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<br /> ' ' Gid
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