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� <br /> APPLICATION FOR-SANITAT1ON PERMIT Permit No. <br /> ^ J <br /> (Complete |n Duplicate) <br /> ^ ' Du+o Issued <br /> � y <br /> pli <br /> 6oro6, mu6o to the Son Joaquin Local Health District for u ponn�t to construct and |n�a||the wvr herein described. <br />' 6e in compliance wifhC Ordinance No. 549. <br /> ~~~ '`~~'`E~S AND `~~''''~'` ------'---'---'--'--------------- <br /> --------------------.----- Phone.-.,/ 12,q--._' <br /> ----------------- <br /> Address--- ~----------------------- --'---'---'—'---'--'----'—''------'- <br /> ContrCnn <br /> actor's Nom�_---.___B�-����~w�,�^-���r�w==-.-_-----__--'- ---------------- Phono-- ------ <br /> Installation <br /> .—Installation will servo: ' Residence Apartment House [:] Commercial Other [] de <br /> Number ofliving units: -_.1- Number ofbedrooms Number ofbaths /.- Lot oizo -- �� --- ---- ---- <br /> W� Supply: Publics�m y�[�mun� system E] P�� � Depth � W�r �6� � <br /> Character of � hoe depth wf�3 feet: Sand [D-.Gravel E] Sandy Loam El- -Clay E]-~ Adob' V Hardpan [] � <br /> Y _�' <br /> . <br /> Previous ��pp|| at|on ��ade: Yes E] No R4.� New Construction: Yo, E] No <br /> ' . <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> /No septic tank permitted if p�6|�� v*�arb *%a8��ew�Gn 200fnet\ <br /> , , <br /> D�t nce from neuna� we|[.--.--D��no�`6nm foundu�on-_----��ofn�bL-..------_---.-- <br /> No. of �m9o�meas .--Size '� Liquid clep�h- 'tomCupu�|� ` <br /> Disposal Field: Distance from nearestw�L��AU� _ <br /> � Di�unce tromoun � �� - n <br /> td�+ioh. �. - .�Ui,h,nm, to e `+ lot <br /> � 'of each �� V ' .Type of filter material--- . ....Depth of filter maferial..../.9 ---------Total length ------- <br /> `~ <br /> �~- ' <br /> Seepage R*: ' <br /> ' I <br /> - ~ <br /> -------- <br /> Cesspool: Distance from nearest 'Well----------------- <br /> ' <br /> from-foundation--------------------Lining material <br /> [l Size; Diameter —~.'.�--�K---------------------Depth-------_ - -� _ ' <br /> � <br /> ga <br /> Privy: Disf ncu from nearest well----------------- from noan,sf building--------------- 1''-'''- \ <br /> [] Distanoy to nearest lot line------------------------------------------------,_�_.---. -------------------------------------------- ---- ------------ - <br /> � <br /> Remodeling and/or repairing /6o,c,ib*\:-______________��__________---________________________:-_____________ � <br /> '—'—'--'---------------'----'-----'--'---------'--'------------'—'—'-----' <br /> _'--'-'''-__-'-_-_-_--__--'_---'-__'-'----_-_.''-_.'--_--'--_'''~'-''_'--_----'�-''--'�-' <br /> ___________._________. _____.__.______.____.____________.____. i __./__._______ <br /> 'prepared and that the °o� wU be done � accordance with San Joaquin County <br /> nrJinances. of the San Joaquin Lpea| Health District. ' <br /> kG�gne6L.-_-..��x����m��x�-�r���x��----' ------- . ) <br /> 8v�-..___'__-..__.._--�-.----._. --- ]Title)- -_---- <br /> (Plot ,lan, showing size of lot. location of system in relafivfowel6. buildings, etc.. can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> '---- _-.-__--. DATE--------------------��� .fr <br /> -_--- -/ PPL|CAT|ON ACCEPTED BY. - } ----_--._ <br /> - <br /> REVIEWED BY'_-'_--'_-'--'.-'/ '--'''�--''-_-''----'- DATE--''''-- ---------------'_-_'- <br /> BUILDINGPERMIT |SSUED ---------------------------------------- _ ----------------------------------------------------- DATE-------------- <br /> and/or recommendations:-------------- ---------------- -------- - ---- --------------------------------------------------------------------------------------------------------------- <br /> ----------------------------------------------------------------------------------------------------------------------------'--'--'-'--'---'---------------- <br /> ------`---`-----^`----``````-----``-----------``---````-----```�``�---````---`````-------``-----`````-------```----``-----------`-----'---````---`-------------`---`` <br /> ` <br /> ---``-``--```----'-`---``--`--``-```--````-``````-```--``—``````—``—````---````--`--`--`-`` <br /> --'----'''—'''''- ------------------------------ ------------—'—''--'-''---'''' —'''--'--''—'''-''-'--- <br /> RNAL INSPECTION' BY:--''--' '--- Date--------- ----- ------------------------------------------ <br /> SAN <br /> ----_.-'--''�--'-''SAN JOAQUINLOCAL HEALTH DISTRICT <br /> /30 South Atn°,j'c°" str"°+ »onWas+ Oak str"=* /»x Sy="m",* mreet o/+ North ''o" Street <br /> sf="kf"". C°i/f","|° L*4/. C*|/fo,"ia Manteca, California Tracy, California ' <br /> es-9-2w10'52no.7s°a wcz,00 <br />