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': �!�•'�:M.....-K:..,re'...,r•..me.•:..r....:K-....W,n.... _...._-., ......_..._-._. ...,.._.. ._. .. ... - , - ,...�.......,J...x-. ...•..._.....n,yF�,.� ,4,,91;, �`, �' <br /> I' OFFICE USE: � <br /> OR � <br /> FOR OFFICE USE: <br /> APPLICATION FOR SANITATION PERMIT <br />€ t-....... ............ Permit No.78...�...7 # . <br /> ' - 1Compleh in Triplicate) <br /> _ .............................. <br /> ... <br /> .. Date Issued./..� <br /> This Permit Expires 1 Year From Date Issued ; <br /> ApplJcation Is hereby mode to the San Joaquin I.ocal Health District for a permit to construct and install the work herein described <br /> This application is made in compliance with County Ordinance No.549 and existing Rules and Regulations: <br /> JOB <br /> ADDRESS/LOCATION...-Z7.7-7......A.�.T :.!•..../f.P.............................. ...........CENSUS TRACT......... <br /> f + ...........Phone............... <br /> .................................................................. ... 4 <br /> I}7 Addre>is...........T 7... .. ./9.+�ref........... .......................................City...�°W-of-C'jr...... . ...... Zip.. <br /> Consti"actor s Name�R.M d<L �M�►r•r�"�t...xwr6tl/t t?.....CAPA/.A-.C..License 7/6•P.R.= Phone.400 <br /> x.Itisfallation•will serval Residence[ Apartment House[] Commercial Trailer Court_❑ , �_ zs ? y <br /> .�...- ....._.. .. .._ Motel Other ..... ��.... <br /> ,E <br /> NUmlaer of living unitsr ...�C/....._Number of bedraoms...._L4..Garbage Grinder.-.........Lot Size...t.ZCl �X..•��Q �� <br /> `gid„Water Supply Pubilc System and name.............................................................................. ... <br /> 5 t . <br /> ., <br /> 'Frl"vate' <br /> Character of soil to a depth of 3 feeti. Sand© Slit Q Clay❑ Peat❑ Sandy Loam Clay Loam[� <br /> 1, r_ Hardpan❑ Adobe® Fill Materlal............1f yes,type..........:._....:...:..:... <br /> (Plot plan, showing ilze of lot, location of system In relation to wells,buildings,etc.mist be placed on reverse side.) z' <br /> �,< .. <br /> s <br /> NEIN INSTALLATION: '(No .septic tank or seepage pit permitted if public sewer is ovalEable within 200 feet,) Ca <br /> ~ _ ; <br /> +.'PA&AGE TREATMENT l SEPTIC TAiK ..... .GO. .: Liquid Depts.c.:: <br /> a Capocity.. Type.:.....................Material...... ..............-:...No. Compartments �` {+ <br /> .� tion........1.D. .........Prop line <br /> .......................FoundaDistance to nearest:Well.... 1. ~A <br /> L <br /> *” Total len th "} ? <br /> LEACHING LINE [�[ No. of Lines...............::............length of each line.. ...............-.......... g <br /> i 'D' Box............Type Filter Material....................Depth Filter Material...' ` t �y <br /> 1 <br /> Distancsto nearest <br /> Well............................Foundation......... Property line Fi». <br /> Depth....r' l......Dia meter.AOXIY Number.............. ......si..... ! <br /> Rook Filled Ye 'No <br /> Water Table,Depth.........................................................Roc :e...� <br /> Distance To nearest WeIL:...f..Cr..�. r ..............:.Foundation Prep Line" �'dr ..r <br /> i <br /> , . <br /> REPAIR/ADN.(Prev:Sanitation Permit#t...............:::...::....:......................0 <br /> 40tii <br />