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FOR OFFICE USE: <br /> R-SANITATION PERMIT Permit No. ........................ <br /> APPLICATION FO' <br /> 4 <br /> -------------- <br /> - ----------------------- <br /> ---------------------------------- (Complete in Duplicate) <br /> ------------------------------------------ -------- This Permit Expires I Year From Date Issued Date Issued <br /> Application is hereby made,to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> JOB ADDRESS AND LOCATION------)j5: 1...South Harvey <br /> --------------------­---- ------------------------------------------------------------------------------------------------------------- <br /> Owner's Name-------------MrArA--- (AKAR Ars.__,Ty"e Johnson ............. 4-21�?5 <br /> ---------------------------- Phone__K9:t.-------------- <br /> Address--------------------------3.64 ...Aquth Harvqy................... <br /> ­----------- .........------------------------------------------ ------------------------------------------------------------- <br /> Contractor's Name--------------- ...Tank Services Inc. <br /> --------------------------- ------ Inc, I-------------------------------- Phone....R9!t - <br /> Installation will serve: Residence [a Apartment House E] Commercial ❑ Trailer Court E] Motel I-] Other C-] <br /> Number of living units: Number of bedrooms .-2_ <br /> -2- Number of baths ---1--- Lot size __59._A_._2_0_0------------------------------------ <br /> Water Supply: Public system L4 Community system Private E] Depth to�afer Table .33. ft. <br /> Character of soil to a depfh'Sof 3 feet: Sand F <br /> _] Gravelo Sandy Loam [] Clay Loam E] ClayF] Adobe El HardpanC] <br /> Previous Application Made:':,(if yes,date.___.-___-,.__.._-- No [9 ' New Construction: Yes [3: No E] FHA/VA: Yes El No [I <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance"from nearest well_________________Distance from foundation--------------------Material------------------------------------------------- <br /> �gisting No. of compartments------------- --------=--Size-------------------------------Liquid depth--------------------------Capacity..--------------------- <br /> Disposal Field: Disfance�from nearest well_________________Distance from foundation--------------------Distance to nearest lot line_______..___.._-- <br /> E�Nisting Numberi;of lines---------- -----------------Length of each line------------------------------Width of trench.---------------------------------- <br /> Type of,filter material_______. --------------Depth of filter material-----------------------Total length <br /> 4 ---------------------------------------- <br /> 10 1 <br /> Seepage Pit: Distance to nearest well-- ---------Distance from foundation----------P......rDistance to nearest lot line___5__,P..... <br /> Number pits--------11-----------Lining material-----rPPX-------Size: Diameter------3311---------Depth-----?5......Max......... <br /> Cessp6ol: Distance from nearest well-----------------Distance from foundation--- ----------------Lining material_.___.-_.__-________________________ tA <br /> ❑ Size: Diameter--------------------------------------Depf h----------------------------------------------------Liquid Capacity- --------------------------gals. <br /> Privy- Distance from nearest well------ ------- ----------------------------------Distance from nearest building_____-.__---.----__-__________.___.____--- <br /> ElDistance"t6,nearest'lof'line-------------------------------------------------------------------------I----------------------------------------------------- ---------------- <br /> Remodelin and/or reRairin�"(describe):-------------------adding--F 1-1t- -�!59d...t..o. <br /> exist--in a t <br /> - -- <br /> ---- <br /> ------------------------- -- <br /> ............................. <br /> ---KV-11Z <br /> ........... <br /> -------------------------------------------------------------------------------------------------- <br /> 2�7 <br /> -----44-'_ <br /> I hereby certify that I Have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and,regulafions of the San Joaquin Local Health District. <br /> (Signed)---------P�fqta Septic' Tank. 3erviqe_, _jnC,__,--------------------------------- -------------------------------(Owner and/or Contractor) <br /> -------------------------- ------- <br /> By:----------------size <br /> Warthft Gen.------- ------------------------------------------------------------------------------- ------ --- gjgr_�............ - --------(Plot plan, showing of lot, location pf system in relation to wells, buildings, etc�, can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED'iBY------ ---------------------------------------- DATE---j_9,.:7:n_L4_....... ---------------- <br /> REVIEWED BY------------------------------------ ........ <br /> -------------- ------------------------- --------------------------------- DATE--- <br /> BUILDINGPERMIT ISSUED-!-----------------------------------------------­----------------------­---- ---------- DATE------------------------------------------------------------- <br /> Alterations and/or recommendations: f --------------=--------------------------•-----.-_----•----.----•----------••---------------.-------------------------------- <br /> ---------- <br /> .......---••----------- ------------------------------------------------------------- <br /> -7 ---------------------------------------- <br /> 3.V-.__6_0 ------- - -------- ------ <br /> - -- -------------------------------- <br /> -------------­--- ------------------------------------------------I-------------- <br /> --------------------------------- .. .......... <br /> ------------- ---------------------------------------------------- --- ...... <br /> -------------- - <br /> ------------------------------------------------ -------------------------------------------------I-------------- --------------------------- ------------------------------I------------------------------------ <br /> :1 --- -- -------------- <br /> FINAL INSPECTION BY:'.---- --------- Date--------- _-_kY------- -------------------------------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street 124 Sycamore Street 205 West 9th Street <br /> Stockton,California Lodi,California Manteca,California Tracy,California <br /> E13-9 REVISED 8-59 F.P.CCI,2M 6-60 <br />