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7 <br /> FOR OFFICE USE: APPLICATION FOR SANITATION"P"M" '���`Oorrnit No. <br /> 71Z FFIC�US <br /> ............ ........ ......... <br /> Ito pie in TriplicOtOl <br /> to Date issued ............... <br /> ..................... <br />..................�/ <br /> This Permit Expires I Your Frain Dot*IsSuOd <br /> ........... ............. <br /> ........... construct and. install the work herein <br /> San Joaquin Local Health District for a permit to cons Rules and Regulations: <br /> on is hereby made to the"S Ordinance No. 549 and existing <br /> ApPlicatl 'in compliance with County <br /> described. <br /> This application.is made .....:.....CENSIJS TRACT ..........­.... ........ <br /> Latae.----...-- <br /> --•----•....----.. <br /> ADDRESS/LOCATION .Phone gn ................. <br /> _PWrM ....................................................... <br /> ..............................­...... ...... <br /> _- ---4M. <br /> Owner's Name ................. city ­­_Stockton.......................... <br /> -.,..Same...............................•-.......... ------- phone ...40n9697----------- <br /> Address ----- ............ ......License # ................. <br /> Contractor's Name ---- Residence MCA.partment HOUSS f3 Commercial{]Trailer Court 0 <br /> Installation will serve: <br /> 0 other .......................... ........ <br /> 4P� <br /> Ms .�.........Garbage Grinder ....-----••- Lot sin 5 .455!............ ...... <br /> ts. <br /> Number of living uni .,I........ Number of bedrooms.4 ............................ ..............PrIvatel <br /> Water Supply- Public System and name=--------------------------- ....... <br /> 0 Sandy Loom 0 Clay Loom <br /> t: Sand 0 Silt 0 Gay ❑0 Peat <br /> er of soil to o,clepth of 3 feet:Hardpan[3 Adobelg -pill Waterial ........... if yes,type ............... ..'..-_...•. <br /> must be placed on'reverse side.) <br /> le,size af.lot, location of system in rotation to wells, buildings, Otc- - -�r <br /> (Plot plan, showing S lable within 200'feet,l <br /> ' - age it permitted if public sewer Is Ovai <br /> NEW INSTALLATION' (N-05�septic.tank or seep p ...................... <br /> Size---.----•-=-•••--�V ......................... Liquid Depth <br /> ! PACKAGE TREATMENT SEPTIC TANIM I -- ----- t . 2............ <br /> ..... No. Compartments ....... <br /> Capacity ----------- Typepre-nGaot----- Materic .301...... <br /> .... Foundation 19!................ Prop' Line = <br /> Distance.to nearest- Well ...501:... .. ......... Total Length 14V........... ........• . <br /> -.4-LEACHING LINE [A No. of Lines .-I------­­........ .Length of each line......UO.............. <br /> .... <br /> E 'D'4BoA­_­..... Type Filter MuftfiOl"Uptu.3k Depth 'Filter Material ............ .............­... <br /> n ............... <br /> Founclatiwgq�;;................. pi�perty_ Ll <br /> % -=61- to-nearest-Well-75W-�------- Filled Yei I <br /> I'sIbnce to ?�L No 0 <br /> 11-- Rock <br /> SEEPAGE PIT De 251------- Diameter- A ............ T, <br /> ------- pt -- .................Rock Size - 9 <br /> Water'Table Depth __-85!------------ !:11----------- <br /> Foundation <br /> . __ .._. prop. Lin <br /> Well ........................... <br /> Distance to nearest- W <br /> Date ................................... <br /> REPAIR/ADDITION(Prev. Sanitation Permit ................................ . 7 .........­ <br /> 1­1............I............. ..........................7j.-�-.­:.......................... <br /> Septic Tank (Specify Requirements) .............. ------L...... ...... .......................... <br /> ---------- ------ ....I—— t <br /> Field tSpecify ge";Uirements] ------ --•----••---•--- ................. ........... <br /> 'Disposal ........­­......... <br /> ............. ........ <br /> ------------ ----­----­---------- .......................... & . .......................... <br /> ---------------------------------------------------- .................. ......... ................ <br /> ---- ------- ----------------------------------- ----- -----------I------ <br /> ------I------- (Draw existing and required on reverse side) <br /> rk will be done In acgordancq with Son Joaquin <br /> plication and Act the W <br /> at I have prepared this op 10 a . <br /> I hereby certify that Rules and Regulations of the Son Joaquin Lo.cal HO 11h,1131strict. HOMO owner or IE en` <br /> County Ordinances, State LOWS ing- an person In such manner <br /> jre certifies the followi - <br /> sed agents signatt i� pe�efo-`--ce of the work for which this permit Is Issued, I shall. not employ a <br /> 111 certify that In the performance Workman's Compensation laws of to become-subject to <br /> Signed ------- ... ... TA 0-------- -------------I.........California.'Mom . .............­­--------------------- .......... <br /> ......... Title _-.,UtiM+j0r <br /> By ----- ----------------- ---- ---- --- <br /> -- ------- ------ <br /> er) <br /> (if ot�er_than_own:7 . <br /> FOX DEPARTMENT USE ONLY <br /> DATEI------:----------- <br /> ------------ <br /> ............... <br /> BY ...... 7 7- ....... <br /> m APPLICATION ACCEPTED B DATE?�­_z_ I.... ...... ....... <br /> -PERMIT ISSUED ----------------- .......... .... ---------------------- <br /> BUILDING . <br /> ADDITIONAL COMMENTS ........... .................... <br /> ......... ............ <br /> ­----------------- .... <br /> -------- ------------------- ------ ......... ............. ------ -- ---- --11---------I------ ­1. .........I......... ..................... ....... <br /> ------------------ ------ ---- <br /> ----------------------­1......­ .. . ......... - ------ ...... - ------------ -------------- ----------- <br /> ------- <br /> -------- .............. ...... <br /> 3H <br /> final Inspection by- -------------------------- r 8/7 <br /> EH 13 24 1-68 likev- 511�-------- OCAL "EA T DISTRICT <br /> JO <br /> AQ <br />