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i <br /> FOR OFFICF I LCF. <br /> I <br /> APPLICATIC- FOR SANITATION PERMIT FOR OFFICE uSE: <br /> Oakdale Concrefe & Pipe Co. (Complete in Triplicate) Permit No.777--g7 <br /> : POST OFFICE BOX 13 <br /> l <br /> OAKDALE, CALIFORNIA 95361 This Permit Expires 1 Year From Dore Issued Date Issue <br /> d.L ---//-7� <br /> r <br /> ;.. P <br /> n 1s ma a in co pliance huCoy in IOrdlna�District$49 a Permit existing Rulers andnRegulat once work herein described. <br /> c ' JOE ADDRESS/LOCATION.4�4S.7!" S1 <br /> . Owner's Name.- ArR T�FJ�/ -...S.I L v.4. -CENSUS T C7E 3 3G <br /> ...... . . ... . <br /> S RA <br /> Address...f'�n..�.ZCd.... P <br /> �v �YC_ hone. •-- ........ <br /> .......... ... . .......... ... City �S�A Ln is �' <br /> ., 2 <br /> ' Contractor's Name A?Lt7 Zip b 320 <br /> dtl ... CO lJ�'�Tt�- <br /> /�c <br /> Installation wi!I serve: Residence ............License #0-6'r-07:74 Phone. ? ' 17G1,. <br /> � <br /> Apartment House [D Commercial C] Trailer Court <br /> Motel v Other...... <br /> Number of living units:-....J........Number of bedrooms..'... _Garbage Grinder.Nv -.Lot Size..r�Ce-�AE.c <br /> Water Supply: Puh:ic System and name......_..... <br /> c........... <br /> Character of soil to a depth of 3 feet: Sand❑ Silt -1 <br /> ........... .....�...... <br /> Private <br /> Hardpan L-, Clay(� Peat 0 Sandy Loam Clay Loam ❑ <br /> P X Adobe❑ Fill Mater;;I.. ... .... If yes,type... <br /> - ....................... <br /> (Plot plan, showing size of lot, location of system in relation to wells, buil;+ <br /> NEW INSTALLATION: (No septic tank or seepage ^gs,etc. must be placed on reverse side.) <br /> pit permitted if public sewer is ovailobie with;n 200 feet,) <br /> .1;. PACKAGE TREATMENT [ J SEPTIC TANKSi �- <br /> ze <br /> Capacity.. <br /> ............... .......... . _ . . ... .....-Liquid Depth ....... ..................� <br /> Mn(✓,V,U P Y.. .._.._........_(ype . ........... ..._ Material....... ..._._. . ..... N <br /> Distance to nearest: Well. ...No. Compartments............................ <br /> 3 ....... .................._..Foundation ... . .._. .. ... .... <br /> LEACHING LINE Prop. Lint............................. 6 <br /> � No. of Lines. ......... .�.`....-.... ..Length of each line <br /> ....`fD _ ......Total Length.......!fb <br /> 'D' Box.. .-....Type Filter MaturiaLl101..�e.t�pepth Filter Material:....L.�.ri.............:...,,. . ......... <br /> _ <br /> Distance to nearest: Well. �� <br /> ......Foundation........'.?......._ . .Property Line ..Z04 r .............. O <br /> SEEPAGE PIT bQ Depth z .1., <br /> ..Diameter 3�1t _......... ...... <br /> Nvmber._........�................ . • I Rock Filled Yes No <br /> S <br /> Water Table Depth.:'....:.._...... <br /> .. ....... .... .........:......::.....Rock Size <br /> ' r <br /> ...... <br /> Distance to nearest: Well. r',Zl� g� , � <br /> ...............•--- -....... foundation . a <br /> REPAIR/ADDITION ;Prey. Sanitation Permit#.UAJe�IJO .. Prop. L;ne.-.[lid=` <br /> ............... <br /> .tIJ... �4�,D......FEta <br /> Septic Tank (Specify Requirements)_. ..._................ . <br /> ......... ..................-........... ............... . ........ <br /> Disposal Field (Specify Requirements)...AD�-.._.•- --'"-- . .I- .• - - - --- -- <br /> `fQ........PF. Lac-a...jL.e,&) r......ko b........R--.......K.Z ..�.- <br /> .......... cc1-1�, ............................................. <br /> ....... ........................ ... .... .. . <br /> (Draw existing and required addition on reverse side) <br /> I hereby certify thet I have prepared this application and ►ha;•the work will be done in accordance with Sar, Joaquin County <br /> Ordinances, State Laws, cod Rules and Regulations of the San Joaquin Local Health District. Home owner or licensed agents <br /> signature certifies the following: <br /> "I certify that ' the performance of th9 work for which this permit is issued, I shall not em ,o an <br /> P ?� Y Y Person in such manner as <br /> to becom lett Work s Co <br /> ensation laws of California.' <br /> Signe f� <br /> Owner <br /> t�Pc..... ...CG r _Title "'J/4K/At-;V?......SAtiIXX:�.7"�o,c). AFpT <br /> (:f other than owner) <br /> FOR DEP RTMENT USE ONLY <br /> - -- __— <br /> APPLICATION ACCEPTED BY. _ <br /> DIVISION OF LAND NUMBER - DATE <br /> ATE <br /> ADDITIONAL COMMENTS..�-Z % d G <br /> .... s <br /> ... .. .......... . <br /> Final Inspection b - <br /> P <br /> FH 17 74 Date <br /> SAN JO UIN LOCAL HEALTH DISTRICT r6S 21677 vEV.7/76 7M <br />