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<br /> tVx tJrrlt.t 4a[: -
<br /> _. APPLICATION FOEt SANITATION PERMIT
<br /> .. .. - (Complete 6, DvAcafa) Dab hewd
<br /> This Permit Expe+ I Year Faom Onto laved
<br /> Appl
<br /> Im%s tmishw*by ode ro ehe Setm
<br /> This apptedos md�i3mn�1ewih My.OHrdioao sNtt o ct51F+a4r
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<br /> )DRESS AN ADy
<br /> Nore �I
<br /> soa perm f f'#cm ruff erd"ny/steh OtheV Wetf a.a.."L P0_M2a_
<br /> e(_l n daasCr/2
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<br /> Ir,t"Foo*3— v Res7dsoce j] Aperb:ort Hesse O Cem"e el [1 T"ur Cs o 0 MoW(3 ONm I]
<br /> Nurnbv of"q ar9s:_._...Numbar of badmom,...._,.NumSer of beth, Lot s'ae_.............__,.......
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<br /> W.I. S.?*: Pull1ic '%Own O Cwrmurily WJ%M I) Pr:#ste . Weer Toble.7,ft,
<br /> r Cfiraoty d ae0 b•daplb d 2 falAs S&"d❑ G"Q Se ndY Laem C Clay loom M Clay ll Adobe D Hndom O
<br /> Preriaus Applkdio.6bda: Elf yn,dab......... ..... ..`, Ns[J Now Coashaction: Ym[3 N.0 FAA/YAi Yea Q Ne C..
<br /> TYPE OF ONSTALLATION AND SPECIFICATIONS-
<br /> thk"P&Nek of cesapsA Pamafbd.f Pebrk ss►er i,we0abb► i-200 fM14 I G
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<br /> Split Yen(;. Distance from resr[af we D"aia tram idaticn,.�L .Melariei -. „. .
<br /> [� No,of cdrperhrenh Sqa. Lewd deyfrh 'i'.,.: Capxlty ,
<br /> Digwael wd! D',s:erca fro„.wrest wax Dlstsmo fapm faurdehas..-. D,flfsGo b e Wl Iluepa_...
<br /> f/two- Number of I'>,., Com, Lo ro oI"ch Rew. , al ..WIdf.4 of hanGh,„, Q
<br /> (fa.(, 'ype at f ter mwe•lel.'„Jas Cf�y,., poytfl of Rlfv mefa"sl,.... �`t' ..7ofe: 4nQ[6,.....jX „..._
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<br /> Sapsga P»: D;dsnu to naemH we0.....__.........._Dirielsq ftasn iauedeMn,-.„,„„.,...,.ONken M nearos'
<br /> Q Nweber of pifs,._... Lining mefensj........_........_. .Sven Ocemstar._ Dwfk._....._.__.�..,.,..
<br /> Cmspwl Ysraece from noo e t w6IL... _DMence ftgm faundef;an .. .. ..LJMmq
<br /> f] $iml Diem.Rc_...............__._._..........OePlh.:_.:...._.................... ...............L*W CaPeaifY,.,...._..__:....,...A&
<br /> Prver Distant#from.merest welt.... ......... ..__................:......_D`efaace fxam allWast
<br /> heUF.q ..._...
<br /> DislwGa to r<erml lq1 ann.....,.>.. ....:...............v. ...«.,.,.....,.,. ...:.,....
<br /> Rerodelirg e�/w rapeir:rrT Idesee5laeJc _. ,..._._..'_.-,_ ..............�._�__...,..«....: ,..........,....,......_.,....._......�.......,.._..._
<br /> I Ixrebyy<arll fy that 16m Paparad 161,appllcef a and Fkm A e k.II be do”iu eaoJrdaoee WA Sas Josge4s Cwmly
<br /> ordirasces 5est lees,,end floe and
<br /> IryNjW/�wne of gtho S�an�J� qun Laud Haallk�($.gad � -W
<br /> md/W Co b*dW)
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<br /> IPW PLn,A01.4 p t6.of lot foeafion aF system in rmfas#n to wets, 4Fanq,.slt„can he pled ft ra+srN tide}
<br /> _.. FOR DEPARTMENT USE ONLY
<br /> APPLICATION ACCEPTED BY a ... UATE.. . ...,,_ ..,_..
<br /> REVIFY40 By ...._ . .__ DATE._.__. ,,.._. . .
<br /> BUILDING PER-till'ISSUED._ ......... . ...__._.. DATE ..._...._._..._... ....... . ..
<br /> ARer�Rons and{or r. ,nmdsMana._. . . .... . .._:..__.:...,....._.__._...__.
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<br /> FINAL INSPECTION BY J,,r/' �`yC..... ........ Oe!#...! D rV/
<br /> SAN JOAQUIN LOCAL HEALTH DISTRICT
<br /> 1410 ew i.llr,al Job cW W. I."!„r:wa ilrara tea Wsr Pe flNY
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<br /> 11/10/2011
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