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FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT <br /> - --- -------------------------------------------------- <br /> (Complete in Triplicate) Permit No. ___73'��_.. <br /> ---------=----------------------------------------------- <br /> ________________ This'Permit,Exptres 1 Year From Date Issued nate Issued <br /> Application is hereby made to the San Joaquin Local Health District for a permit to constr'ct and install the work herein <br /> described. This application is made in compliance with County Ordinance No. 5.49 and ex -tin ;Rules and Regulations: <br /> JOB ADDRESS/LOCATION -` F, .Sf _ ----' 7 --, .r1___- � -��jE�4N�S/US TRACT --------------------__---- <br /> Owner's Name r ff !! l <br /> '� i Y_ll 1- - h J , I r'-------[•-------Phone ------------------------------------ <br /> Address - -------------- 3 --------------------------------- Ci )------/-- -------------------------------------------------------•-------- <br /> n ---.Li eri j ' <br /> Contractor's Name ---- -1'(�-----4C----------- ___ ------------- se # �1-� 1----- PhoneJ ' <br /> Installation will serve; Residence, partment House❑ Comme tial ❑ railer Court ;❑ <br /> Motel ❑Other --------------- ------ --------- it l <br /> l / <br /> Number of living units:--------�__ Number of drao '_ ____-_"Garbage Gr de _._ Lot Size , �Z_. _ ---------------------- <br /> a G� _______ <br /> Water Supply. Public System and name - - E11 :_ ___ __IM <br /> f--------------------------------------------------------Private ❑ <br /> Character of soil to a depth of 3 feet: Sand'❑ Silt❑ Clayeat❑ Sandy Loam ❑ Clay Loam ❑ <br /> Hardpan ❑ Adobe Filici`I _tel _ If yes, type ____________________________ <br /> (Plot plan, showing size of lot, 'location of system in relation to wells, buildings, etc. must be placed on reverse side.) <br /> NEW INSTALLATION: (No septic tank or seepage pit permit ed if.public sewer is available within 200 feet,) <br /> TREATMENT { ] SEPTIC TANK [ Si __/7�__ `'_ �' =r Liquid Depth ._`� ..______. <br /> / 't-�_ <br /> • Capacity - ro___---- Type ton___ ---- ___ Material- No. Compartments ------------ <br /> --------- <br /> Distance to nearest: Well ___ r_ _ '� _ _ _ Foundation _��_�_.-__.___ Prop. Line ��______________ <br /> r � � <br /> LEACHING LINE jj-"No. of Lines ____v`��_-------------- Length o each line___'6:"e' _CY. -_---- Total Lengthd__........ .. <br /> 11 __ I �� <br /> �14k <br /> D' Bax _' Type Filter aterial AC <br />