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FOR OFFICE ,USE: ^ ®� 3 S ySTEM 5 - p <br /> �.. ....................-1— .... ......- Permit No. ..l <br /> APPLICATIONgOR SANITATION PERMIT <br /> ................................... 1� ;, . ldr � .w. . <br /> r <br /> _ ..,•..�•jZ'omplete•in-bupliaa#e)---�-�""•^"" Dete Issued -----.---��� -•E' <br /> This Permit Expires 1 Year From Date Issued _ _ <br /> Application is hereby -made to the San Joaquin Local Healil District for a per to construct and install the cA IN@scribed. <br /> ' This application is made in compliance with County Ordinance No. 549. h) <br /> JOB ADDRESS AND LOCATION_ 1V- - -- p---------------------- <br /> 6 � � �. rR...-.__P.f} ......_...................... Phone... ... <br /> .. <br /> Owner's Name--------- / 4 e---._ ............................. <br /> omnercialf Trail r Court Motel <br /> Address............ : ..L.._ ... �L... l.O_ I�K__ D � ... �0 P�C}'�..........MC7DJ�Sl'6 <br /> 1. <br /> .. - -. hon <br /> Asle�c�,���s <br /> Contractor's Nameuq.:_t[vrsr�--.. ❑ Other ❑ <br /> Installation will serve: Residence f Aparfinent House ❑ t <br /> Number of living units: _.�---. Number of bedrooms .--- Number,of baths ._ .--. Lot size ......� -• - <br /> Weter $y I : Public q stem �ornmunit „s ;Iecn__f,r,riye4e,• Depth 7o Water Tem lO • f+• <br /> P y------ Y 0- . Y Y P <br /> ' p Grovel Sandy Loam❑ Cla Loam Clay ❑ Adobe❑ Hardpan❑ <br /> Character of sob to a depth of 3 feet: Sand ❑ y <br /> t b FHA/VA: Yes ❑ No <br /> Previous Application Made: (If yes,dote....................) No {J New Construction: Yes [I}�No ❑ _ _yY_ <br /> s ; <br /> ' - TYPE OF, INSTALLATION AND SPECIFICATIONS,,t .,yig �' <br /> (No septic tank or cesspool Per <br /> if pubGq +art s�v, a6tlwithin 200 feyer'+� <br /> J�$efic nk: Distance from nearest well__�_...Dlsta�eoytLatiLquid� ih_s�TI/Material.- <br /> I - Pp ' <br /> No. of compartments__..-- <br /> -..-..Size- _ ,? <br /> ' Dispos .� _ Width of trench....... .. .. C <br /> geld: Distance from nearest well..s50--..-Distance from foundatioa_..� Distance +o nearest lot - -- <br /> NnrRtYat'of lirl�s"'''"�:�'"'-'"" •LB'h�Yh`6f'each 11n's"`.�8.. '.yI �� (� <br /> Type of filter material_.QCK_--Depth of.filter material-_-..� -__..f...Total length......_-.... �•-••--.• .-:� ` <br /> ' ,`Q_..._.Distance to nearest lot ling- <br /> Seeppa Pit: Distance to nearest welLlbp:•--•--Distance from founds=ienDiameter.f,�_X-.l_5......Depth___-/V---------_--------- <br /> /�f ' Number of pits._.....------ ---•Lining ma on <br /> / <br /> Cesspool: Distance from nearest well.................Distance from foundation....................Lining materialy----------._------ ---- -als. <br /> ' Size: Diameter---- -------.Depth---Vic............:..............................Ugwd Capacity.........---------..._......g Q <br /> ❑ - ; <br /> _ _._.__Distance from nearest building.......................................... .� <br /> Privy: Distance from nearest well--............... ....-.._ .._.............-................................ <br /> ❑ Distance to nearest lot line..............._.------.---.----------------------- ---------------------------- <br /> .­ <br /> -------------__- <br /> ' Remodeling And/or'reairi (describe):- - ........ - - - ...__...... — .......................... ......:_............. .-..... <br /> ................................... .......................... <br /> .............. ..----- -- JA..................................... . x <br /> `: <br /> 1, ' <br /> i tnances------------------- x ra-.... <br /> ...................----------- -----------------------........---...--e..-.....................cco ---nce_................Joaquin <br /> I hereby certify that I have prepared this application an +hat the work will be done in accordance with Sen Joaquin County <br /> �i State•laws;ierid r lesraaderegul ons r14 Sa .Ji�o�aquin Local Health> District. ��� <br /> � . .�.•-r-- h.... ....... ............ . .(Owner aind/or Contractor) <br /> - . . <br /> Z (Signed) `` t ' r .r`t� Zk T (T'ifle)... <br /> .. ; - .. <br /> By;-------...._---.._-..--------•-----......•.... etc., can be placed on reverse side). <br /> .... <br /> ' (Plot plan, showing size of lot, location of system in rete ion to wells, buildings, <br /> FOR DEPARTMENT USE ONLY r <br /> __-.-fir <br /> -- DATE..:. ./.-.� . <br /> APPLICATION ACCEPTED BY.- �•...... <br /> - \ <br /> REVIEWED BY----------------------- ------------------ ----.............--............-...................................-- . DATE---•-- ------ --------------------------------... <br /> ......._............................ ------ DATE--------------------------------------- ---------------- <br /> BUILDINGPERMIT ISSUED__---...------------------------------------ ...••.--.......... ..... . — <br /> Alterations and/or recommendations:..... _.......................................................... ------ - ... =..... <br /> ' ..................................-•--........................................................................................ ........... - ........ --.... -— ......-. <br /> ................._. <br /> ----------------------------- <br /> I' - ...... ._....._.._._ .. _ .. . - - ._.-.......... <br /> ........ <br /> .... ------...._ <br /> ' ....................... . .._ Defe....... v _ ._------._-------....... <br /> FINAL-'INSPECTI - ---- .. .-- - <br /> ' SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 724 Sycamore Street 205 Wen 9th Street <br /> 400 Wen Oak Soret Tracy,California <br /> 730 South American Street 300 <br /> Caiifornia <br /> Stockton,Collfomto fedi,California <br /> ES 9 REVISED 5-59 2M 5-62 ATLAS <br />