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�~ =OFFICIUFOR OFFICE <br /> �~~APPLICATION�� �� FOR SANITATION�� PERMIT <br /> ERmn Permit No. <br /> -` `~�^ Triplicate) Dote |yooed <br /> ----------------------------------------------- <br /> -ite Issued <br /> ---- h to construct and |n�oU the�_~o2- <br /> r7k--,h�-e�r�- <br /> -n <br /> Application is hereby d tothe San Joaquin Local Health District for p ��� and edoM"y Rules - Regulations. <br /> is made |ncompliance vhh County Ordinance No. <br /> �~ <br /> descrIbed. This application <br /> � <br /> ~1� <br /> ' <br /> iaI:.0TrcflIe:r Court [1 <br /> Installation will serve-." Residence Apartment House'F­l Commerc <br /> Number of living units ---- Number of bedro <br /> : ?.-Y I Clay r-,l Peat El Sandy Loom -F] Clay Loam 'Ej <br /> Character of�oil to a depth of 3 feet:�,' Sand 0 Si It C-1 <br /> . must be placed on reverse side.) <br /> ;kot-' location of sysn � n/� "" '" ~~ ^' ~ <br /> (Plot plan, �ovng size of ' I . ^ <br /> NEW"" °"~~~-A^^~-' �np � ���w �� p�N� � ,�|c �� isavailablevhh|n �feet,) <br /> " - Liquid Depth <br /> PACKAGE TREATMENT !SEPTIC TANK{ S��. ' . . .-' - <br /> ~- <br /> y ---------------------------- <br /> LEACHING <br /> . -----_------ <br /> Capacity <br /> '- <br /> ---' <br /> Copodry |--'-'--- Type _'-_ ~`'-. Nmh��| �-.--- No. Compartments ------ <br /> Distance <br /> - <br /> Di�onna �- noones� Well __'_�-'_'---_'Foundu�mn ---_-- P/op. Line --------------------- <br /> of <br /> '^-+ - <br /> of each |hnm Total L ��H� ' ' '____ <br /> LEVCH\NGUmE No. of Lines '' <br />� -----�� <br /> ~-`r,' Filter- <br /> Material <br /> ------------------------------------------- <br /> 'D' 8ox �--.. Typa Filter'Material <br /> ine <br /> "~ ---r'»p='x ^ <br /> Distance to '��� '°"n6mt' ����� <br /> ^~/ Yes No <br /> SEEPAGE RT Depth ' ' D|omater ' '_-- Num6*r '' <br /> J <br /> \ -�-------� <br /> *-e��. -Rock --' -' --' - <br /> ----)'- <br /> Vater -:-.e Depth , _.-._________^_'-� daMon .-- pro p <br /> 'op <br /> �una�,` <br /> ---__'- <br /> A Foum <br /> Distance m4Dote ---------------------------- <br /> REPAIR/ADDITION <br /> . _ _-- <br /> R=, (Prev. Sanitation permn# ' -_ <br /> ' ^r�X- c � ^ � ' ���� .��^~_______ <br /> D|apmso| Field (Specify Requirements) - em� ,-=� ��' - - u� , <br /> 0� <br /> __ <br /> � � _--_-_-___'_.----_----'--._-''-'-' <br /> � n' ' d <br /> r-e addition on reverse side) <br /> '~- existing- ` qthat the work will be dwmw in am*mmdamcw �qM� �m� um�qmn� <br /> 'I hereby certify that I have prepared thismm�n �mp <br /> Home owne or licen <br /> �wn��� �r�inmnumm B��m Laws,!and Rw/mm and Regulations of __ -_ ^ <br /> ' sod agents signature certifies the rw«�°~i �p �� vv��� ��� . � � ;` �wpmw�, n u�w)y ��' ��p�� �m� ��r��m on such manner <br /> > `1 certify that 1n �h� ����rmpnwm mr the work <br /> ,_.. <br /> ` as to be;ome subject to Wor laws of California. <br /> | ' (|f other �vvne� FOR <br /> NY USE ONLY <br /> BU\U}|NE> PERMIT ISSUED ------------------------------------------------------------------ <br /> _________.___.-----'___.___.____. <br /> ADD|T'|ONAL-CON\��ENT3____. _____________-_' _'_`. _�_________________________._^ -------_______-_. -___________.--� ---------'-----' --'-' <br /> -'--'-'-'_. ---'--- -------''-_'Do�o - «=r..^��_--'. <br /> Rno| |nspecnonby- -- <br /> SANJOAQU\N LOCAL HEALTH DISTRICT <br /> . ` <br /> E. H. 9 ' 1''68 Rev. 5M <br />