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4eo. 14 '94 9:10 HAROLD CAMPBELL CONTR FAX 619-74F 936 P. 2 <br /> FOR OFFICE USE, <br /> AlKICATION FOt SANITATION PERMIT6 nk <br /> . . . , ICilmplole In TrIPI1cetM <br /> Permit No. ...7...:........... <br /> _ TWO Permit Implies I Yaw From Do"united Dote tocued..G..:s..'�.... <br /> Application Is hereybyy mods le the Son Joaquin Local He*%Dlshkt for a permit to construct and Install the wools heroln <br /> described.This opplloolon It mode In camplionca with County 0 dlnan,y�Ny"q. Sep end misting Rubs and RagularimY <br /> JOB ADDRESSAOCAT LO..��._ .e. .. .. .�• W/TQ_7rCENSUS TRACT ..... ............... <br /> Aarm's Nome �. .....phone . . .................... <br /> A"r..a +aly ' <br /> CatkaDors Nam. .._........� . <br /> .. ...... ._4.E.Y'+Cllansil N ....... .... ....... . Phone .... .................«.. <br /> Nstetlatbn will serval Resldenea ji trtseM Nauss[)Commordal QTrolloo Coon Q . <br /> A&"p Other........',..[. ........ ...................... <br /> Nwnbw of IlvhV imdtu...�..... Number of bedrooms ...r_.Garbage Grindw ... . ...... Loo Sirs ..... ............h.........0 <br /> Wow Supply) Public System end noms ............................._...................._................................................... Z . <br /> Owroew of call to a depth o/S lever Send❑ ills Q p Pilot p Sa dy Loam p aay Loam❑ Q <br /> Hardpan p Adoba ff Fiu MGWI*f...........If we.type........................... <br /> 1Moo plan, shewlfhg she of lot, Iacallon of syttern N rsimloa to wells, building$, etG mutt be placed an revww sldaJ <br /> W <br /> ! tnALEATEON1 Die eeptk lank or w s Pic Permitted If public sis available within 200 11003 / <br /> *�TMDa () UIPTIC TANK ww itrs..tr /../..�it .. ...... . Uquld Depth ...O/................rV <br /> Capodty .I AC.Q..... Type .Ct AIawW....&e2-%.C'.:... No. Comportmeeds ..9........... <br /> / Distance to noornh Waif .........Jr..C....................Foundatlon... ./Lc.......... Prop.Una. .......... <br /> LEACHING LINT! (/I No. of LLws . ..6.........._. Length of each <br /> nhh IIM_.._.' C.'...... ...... Total Length ../�R............. <br /> •D' Som .....(. Type Filter Maplerlal .... '.fl........Depth Filter AAalerlol . ..��.�:............................. <br /> Distance to swamis. Well ....... ...... Fouindatian . . L.f�,f: . Propeny Lino <br /> SEEPAGE PIT // .s 2-O N <br /> 119 Depth ..r,?s'�ft..- .�rl ...... <br /> DlomOw ... umbo+ .Z/........._. Rock Filled W$ j�No <br /> Wotan Table Depth ..............! F.'.A.'.....................Rock Sirs ...�,r1...,�.3. <br /> Distance to newest.Wall ......../C1AC.-A!"..............Foundation . .../C`r*� Prop. Line ...5 ..... <br /> REPAIR/ADDITION(Prov. sanitation Permir0 ............. ... ...... ................ Dole .... ................ .. ......i <br /> Septic Tank (Specify Requimmisntsl .... . . ............................................................. .... . . .. ... ....... ..................... <br /> Disposal Add (Specify Raquiromenlsl ................ . . ................................ ...... ........ .... . . .. ............. <br /> 10row s:Wing and uquired addition on cevarso sidel <br /> 1 hereby certify that I haw pre;oreel We arPllcollen and that the week will be dons In accordance Wills Sen Jileg <br /> County Ordinances. Stoto Laws, and Was and Rtgulotlont of the San Joaquin Local Health Dlsldcc. Noma *wave or <br /> SW agen4 signature certifies the tolls dng: <br /> "I certify that in the performance of the work for which This pormit I. Issued, I shall not employ any Parsee, to such meMw <br /> of to boreme subject to Workmen's Compeasolion laws of Colifemie:' <br /> Signed / / � ... er <br /> .Own <br /> by �114lr t� :�F��"� . Jill*.41fe c, (s. r l: . <br /> pt other than owned FOR <br /> pp FOR DEPARTMENT USI ONLY ' <br /> APPOCA11011 ACCEPTED BYDATE 7�"_ /T <br /> BUIL LING PERMIT IS:UED 00 0 DATE <br /> ALLIIIOIIAL COIAIAf11rI <br /> f�.�o1 mei.„•on L/ <br /> :..I ,.*-'A'1: 'f,ral i1FAITrt DISTRIfr •flj71/ t3M� <br /> ._ r <br />