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"SANITATION PERMIT,_ Permit No. .3 <br /> APPLICATION FOR. <br /> 02160210 jCo late in Duplicate) Date Issued <br /> 'm late in <br /> 'Jul P <br /> Of le 4001111, <br /> de:rto [lilhTan .16aquianlcai He th is rict for a per'�it to construct and install the work hereir.described. <br /> A ry <br /> TZI el: nee with County ordinance No. 549. <br /> application is made in compliance 4 ' '7—Z/-. <br /> JOB ADDRESS AND ....... ............. <br /> hone.._. a _7J.t............ <br /> 4.&................................. <br /> Owner's Name....... ...... <br /> _N ....... - <br /> ... <br /> .......... . ....... ... ................... ......... <br /> Cj=tractor's Name...09..9A...Ef ....or..S.Otev.x............ ....................................... Phone_.. <br /> A <br /> Commercial:f [0 Trailer Court 0 Motel [:1 Other C3 <br /> t House 0 <br /> Installation will servr- Resi$e� �P�a : " <br /> s- Nuniber of bat�s, <br /> Number 4o jv6i`ngun_ifs-I—Number bar of bedroom__.;'._ ........ Lot size ................................ <br /> b <br /> ft. <br /> Water Supply- Public'system C3 Community system 171 Private E] Depth to Water Table <br /> C <br /> Character of soil to a depth of 3 feet: Sand [] Gravel C3 Sandy Loam [0 Clay Loam El <br /> Clay C] Adobe Hardpan 0 O <br /> if No <br /> Previous Application Made: Yes ED NoEY New Construction-. Yes 0 <br /> ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet-) <br /> t - .../D........ <br /> arest well...............Mstance" from foundation....................M ...... <br /> P; <br /> Distance from no A Liquid clepO.......X0...........Capacity..070T <br /> 6:0 ;70 No. of compartments....._'-....t/.........Si,e­­ A'.AJ ............ <br /> 11", *'� , ;. . 1, . oundatlyn-.J.64...**......Distance to nearest lot line. .60 1 <br /> 14413"84�_ Distance from nearest weil...id DistanW,��J.Ppad� ........... <br /> 'f ­;i�-4-49tt OT eac line.`V­ <br /> Number oi .I;nas3..Ae. i <br /> -----------—------ ----------- <br /> .................__Total length.........._ or <br /> TypS 16f filter rilaterial.. ... of filter material IF <br /> f . a I rest lot line.Zo. <br /> Seepage Pit: Distance to neares�w_ell..10!�..........Distance from foundation_C <br /> .0........Distance to nee <br /> Dep .... ...... <br /> Size: Diameter...'Y'r., th...... <br /> Number of pits........I............Lining materia ....... Lining material..................................- <br /> Cesspool- Distance from nearest well.._... .....-Distance from foundation-------.......... d Capacity........................-ga's-, <br /> Uqu' <br /> Size: Diameter......... ..... .................. ........._.............................. <br /> 0 - of stance from nearest building............. .............. ........... <br /> Privy: Distance from nearest 611................... .........---..Di <br /> rest v�e <br /> F-I Distance to nearest-lot line............................ <br /> ............ <br /> .......... <br /> (doscribel- <br /> Ram ng end/or::7i4ntc <br /> .......... • <br /> ............................................. <br /> ........... <br /> ................... ....... ......._. ......_._.........._.w_....... <br /> ..... . .. ....... ... ... ........ ............ ... . ...... <br /> I her.a.b.y..certify. ..the.that..I-have..prepared. . this.. application. . .. ..and that..the. . ..work will be done in accordance with San Joaquin County <br /> ws, an rules 't " <br /> ordinances. S+at" d I an gulartion4s of the San Joaquin Local Health District. <br /> ...................{Ownd/or Contractor) <br /> lsigned�.......... .. ...... .................... <br /> ............ <br /> BY:.... . ...... <br /> (Plot plan,, showing size of lot, location of system in relation to wells, 6uildings, etc.,, can be placed reverse <br /> MA MENT SE ONLY <br /> ....... DATE._/, <br /> APPLICATION ACCEPTED 8' . ...... ......... <br /> REVIEWEDBY.......................:.................. ....... ............... DATE_ <br /> BUILDING PERMIT ISSUED..._............... DATE..... ........... ....... .._............»_ <br /> Alterations and/or recommendatilans:...................................................—-—-----------------------------------___._..___.._.....»_.-----.----- <br /> -----. ................................. <br /> I! ..............._.__....____._._..._.............»_ <br /> ............................................ <br /> ..........­1.......................................................I............ L---------------------------------- <br /> .................... .......................I........... <br /> r, ....................... . <br /> ......................... <br /> .....................................»»._^.... <br /> ............................................................... ....................... <br /> ........................ ......... .............................. ­............................We, ...................................... <br /> Date....b....­. ............................................... <br /> FINALINSPECTION-; ...... .. ................................................ <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 132 sveamero Stroaf 814 North "C" Street <br /> 130 South American S0601 300 w0fit Oak Sfre&t Tracy. Carlforn;a <br /> sftckfoa. California Lodi, Cal;forn'la <br /> Ma eta, CaliforaL <br /> ES--9-2M 1032 Revived W-2100 <br />