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FOR OFFICE t- )E <br />Permit No. <br />APPLICATION FOR SANITATION PERMIT <br />........................... ..... ... ....... <br />............. ............... -1 ---- ....... (Complete in Duplicate) Date Issued <br />------- ----- -- This Permit Expires I Year From Date Issued <br />V described. <br />Application is hereby made to the San Joaquin Local Health District for a permit t construct and install the work here' <br />This application is made with County Or finance No. 549. <br />AV <br />ie--- — --------- -- ---­------------- ... <br />JOB ADDRESS N 4A—) .................. <br />AQOwner's Name.__ - ------- - - - - -------- --ef— Phone .................................... <br />*-e� <br />------------------------ <br />--------- _ <br />----- --- <br />Address--- <br />- <br />Address_ e�--- r <br />Phone./..... <br />Contractor's Name .V ------ ',_A--------------- <br />4'. <br />Installation w1I,seve: Residence D-5artmerf House <br />E] Commercial E] Trailer Court El Motel 0 Other 0 <br />.. ............ <br />& <br />Number,of living units. _/.". Number of bedrooms Number of baths _/?mot size ---- //0- <br />Water Supply. . Public system El Community system C1 Private U�-�epth To Water Table CN57:2J* .. <br />4. <br />Character of soil.to a depth of 3 feet; Sand E] Gravel El Sandy Loam [:] Clay Loam [] Clay [3 Aclob �rd 0 <br />I No 95�_<el Construction: Yes `lo 6 FHA/VA: Yes ;'No El <br />Previous Application Made: (If yes,date ------- ----- <br />TYPE OF INSTALLATION AND SPECIFICATIONS: <br />(No septic tank or cesspool permitted if pub' sewer is available within 200 feet.) <br />r J V 119 U-terial 97�11 <br />Distance from nearest well. Distance from a on.-. -------- I ---- <br />Septic Tank: Z 11 .1 - Liquid depth _,4 ...... Capacity ... J.."LL <br />,C5. _. <br />No. of compartments- .1 L-- — ----_-------- size <br />lot line.-... P57V Distance from foundation.._.... nearest ' - <br />)n to <br />Disposal Field: Distance from neirr1well..1.1... . ...... Dis an <br />Number of lines___ ------ ----- ength of each <br />_�_idth of french. -..-AA --- �/ ........ <br />Type of -filter material- epth of filter material, -..-Total length .... S.D., ------------ <br />Seepage Pit Distance to nearest we --- /. "__ --.'."/Distance from foundation ------ 10_0..Ssiance to nearest lot line_..__ 41' ---- <br />Number of pits. ..... . *;� — ----- I Lining material..p c/i ----- Size: Diameter - ,?&-l-'" ........ Depth -.,,Q--4^-. ---------------- <br />Vf o d)a ---------- ...Lining material ................... _--------- <br />Cesspool: Distanct from nearest well ................. Distance fro un tion.-.... --------- <br />.................... ....................Depth__---------- ------------ ...... ----- ------ Liquid Capacity.... .......................... gals-5�.. <br />Size: Diameter_ ----- -------- �i. <br />Distance from nearest well .................................... <br />Distance to nearest lot line ........... ---------------------- <br />(describe):- -- --------- <br />.__.0 <br />iearest building------------------------------------- -- <br />----------- . .... .... ......................... ___ ............ <br />---- -------------------------------------------------------------------------------------------------- --------- -----•-----------•-------------------•-----•----------...- ­­ <br />------- <br />...... .................... <br />I here6y,,ce ifly that I have prepared this application and fha+ +he work will bed in accordance with San Joaquin County <br />ordinances, St WsOnd rules ised regulations of he San Joaquin Local Health D* ric+. <br />.... .............. j__ ................ pilasusaiijlllft ContractorIC <br />itle) <br />(Plot plan. showing size of lot, location of system in relation ... ----_---_-- - ------------ ­ .. .......... ........ <br />(Signed)-- .... -- ..... <br />............ --------- ----- (T* <br />By------------------------ -- 7 i ills, buildings, e can be placed on reverse side). <br />on t e <br />FOR DEPARTMENT USE ONLY <br />E----- J_ ----------------- <br />APPLICATION ACCEPTED BY --.-T . .............. _ ---------------------- ------------------------ DAT .... <br />­-� -- -----_------------ DATE-_ .................................... ----------------- <br />REVIEWEDBY.. --------------------------------------------- - --------------------------------- .1 ­ ...... DATE - ------------------------------------------------------------ <br />BUILDINGPERMIT ISSUED------ ------------------------------- ---------------•- ------ <br />----- -- ----------- ­ -------------•--•.•------ <br />---------- ** ------- <br />ANtrations and/or recommenctafions; ... .......... ......... I -------------- -•--------------••-----•------•.._..---__...... .----------- ------ To ------- 5_tq_"�'D <br />......................... ................... I ................. ------- _F <br />� -P-t- V�F_T' JW5 40� ...... 111-_ .............. --------- <br />................... ­ . ............ ------------------------ ­------------­--- <br />f-ri I -------------------------------------- MR -01 <br />-- ----- ......... .. .. ---- ------ - ---------- <br />------•----------------------------•--------- .. .... ...... ------------ ............. ............. <br />-------------- - <br />FINAL INSP N B ------ <br />- ------------ ------------ <br />............................I.,....... _.--------- <br />Date__._____. 3----------- —_ ------- <br />z <br />130 South American Street <br />Stockton, California <br />ES 9 REVISED B-59 2M 5-62 ATLAS <br />SAN JOAQUIN LOCAL HEALTH, DISTRICT <br />300 West Oak Street 124 Sycamore Street <br />Lodi, California <br />205 West 9th Street <br />Manteca, California Tracy, California <br />