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fi <br /> FOR OFFICE USE. APPLICATION FOR SANITATION PERMIT f / <br /> Permit No.6#Z : .!461:?, <br /> '`" (Complete In Triplicate) <br /> .............................................. <br /> Date Issueda/u._� -./�.% <br /> - This Pe rmit.Expires i-Year From Date Issued <br /> 4 ! Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein <br /># described. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: <br /> (So. of Ni a 50) <br /> JOB ADDRESS/LOCATION�C.206+3'_.So�.._Hata..Ewa.s.....TZI.Q .................I........C1:N5US TRACT .._... ............... <br /> x <br /> Owner's Name .. ... .....$._.f.-. 9T.LEy...............................:......_..._................_..__._........ Phone ...835- 4349..... <br /> . .-...... <br /> Address Ss r..xQu e...slut.h.._Q '...Ira- lex...house.............City .....TracY.......................................... <br /> ....:�:.....__ <br /> Contractor's Name ...... l�, '1QUIS ......:.......Lice # .9.9594...__..... Phone ....$3Jr�3�,V4.._.. <br /> k <br /> Installation will serve: Residence®Apartment House❑ Commercial []Trailer Court fl <br /> Motel❑Other........................................... <br /> l .. _..... <br /> a. .:. <br /> Number.of living units,............ Number of bedrooms ,....2..:.Garbage Grinder .._-........ Lot Size _.ACprB�B.........:.-. <br /> Water.Supply. Public System and name "' <br /> Private <br /> Character of soil to a depth of 3 feet: Sand❑ Silt❑ Clay C] Peat❑ Sandy Loam o Clay-Loam L[j <br /> Hardpan❑ Adobe 3XFill Material If yes,type ••-- <br /> ;(Plot pI h,.showing size of lot, location of system in relation to wells, buildings, etc. must be.placed.,a reverse.islae.) ).3 <br /> :. <br /> { <br /> NEVI►INSTALLATION: (No septic tank or seepage pit permitted If public sewer is available within 240 feet 1 � <br /> F: PACKAGE TREATMENT [ ] SEPTIC TANK{ ] Size................................................ Liquid Depth . <br /> ks'' <br /> ......... <br /> .............. Material__ ..... No. Compartments Type ...... i <br /> Line t ...... <br /> rest: Well ....................................Foundation......_....._......... Prop.to nea <br /> Len-'ti of each line........................._:: Total Length..:. <br /> . , ...............• <br /> LEACHING LINE ( ] No. of Lines ..................... y.. <br /> 'D' Box ._-......... Type Filter Material ................... Depth ^� .._.............._. <br /> _ Filter Material ' <br /> Distance to nearest: Well ........................ Foundoti n ..................... Property Lina <br /> <r SEEPAGE PET. [;J �ef��h�•................... Diameter ................ Number __.__....... ........... <br /> Filled - Yes © .. Ido;Q. <br /> -^---- Wdfer�'Fable Depth .....................................�.'_�_R ck 51z ;: ___....... ............ <br /> WWer. <br /> ... -151 + <br /> �vn ion ....... ........ Prop Llnsstancef�nearest.- Well ..............._._._........._..�._... chat <br /> i � <br /> j REPAIR/ADDITION(Prev,Sanitation tPgrmit.d�.....................................i.. <br /> Ptic'.Tartk,l5pecify Reauirert�hts�'." .#"::�aC.j.S�r [l$:..::......:i--�-t T... .........V�-. � { <br /> .. 13 _ ._ <br /> Ufa Disposol Field IS pecifyvRequirerrikntsl ......._. IIS &a. 7Jg...�}�...a�A•• *. 1Ftt Fid -Sl�pl-@�Bi1 lT�`gni <br /> ........ ... ...... <br /> leachiia dxain r� ox .... <br /> i 8 ._�-.._>I.. ... i <br /> f ,L, f ...... ---•••-- <br /> .................................:....•...........-••............I...__.._......._. ...........................................,.. <br /> jDrow existing and required addition on reverse side) <br /> 4 .I,hereby certify that t have preparei this application and that the work will be dons In'cttordance with San`Jooquin <br /> «; <br /> �,:s_,•, ; County,Ordinances, Stats laws, and Rules and Regulations of the San Joaquin Lacal.Health District.Home owner`er Ilton- � <br /> agents.slgnatnid certifies the following: 1 <br /> .'.:.. "I certify that in the perf ce of the work for which this permit is issued, I shall not employ anypersen in such m6nner <br /> as to become sub)ect to ark an's Compen laws of California:" 3 <br /> P�7JUIS"r PTS <br /> SE CE <br /> �- ..Signed .:... ....-_ ... <br /> Tide ..Managq .- <br /> ........ <br /> w By: (tf other tho owner) _ <br /> '' F _•.: F R DEPARTMENT S ONLY <br /> 5 • v <br /> w+ �Y <br /> f ... ........._•..... .. ...... <br /> APPLICATION ACCEPTED BY.......................................... ......... DATE. I � :.. <br /> ::. BUILDING PERMIT ISSUED........:.:..:..... ...... DATE_..............._.................:....... <br /> ...••..•................. <br /> ADDITIONAL COMMENTS ......... ..... ..................................-.:--........................... <br /> ............. <br /> ........................ <br /> .................................................. ........._......._..........._.._.. <br /> ...__...... .._... <br /> .,nal Inspection by .. .............•.....-_.:_......_............-_....._.._..... .. *LRICT <br /> M....._....Date ...L :p�C � } .}..._.._ <br /> SAN JOAQUi L AL HE { <br /> t ? N <br /> E. H. 9 W68 Rev. 5M.% <br /> al rat,,.w.,« -^ '�ws�i+•� ...,._.....—.t .� .- --. �...... ... - - - <br />