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:OR DEPARTMENT, VIONLY :1 <br />API CATION AC.C.E-PTED BY <br />REVIEWED BY . . <br />RtiltDING PERMIT ISSUED <br />Alterations and/or recarnrnendeliek: -1 <br />i _.. <br />,- ..., .• / , ,, : i• "' 1, ' - <br />INAL INSfEC,TIOU <br />r <br />•••••I•••• l'•••• <br />1.•fb•••• c•' le• • ft <br />• <br />V .•try • 411 1.114 ••• ••••• <br />of . <br />4 DAITE.t. <br />DAtb <br />DAI'LL:244.',:: <br />• <br /> <br />'1444-t‘"*!....• ' oe • or, <br />.... <br />.. <br />; <br />7 1 3 • to ••• <br />To•tror <br /> <br />.Nr"ty-ATION FOR SANITATION PERMIT <br />(Cemplet• In DeplIcele) <br />t fskires 1 Yeas FlOrfl Date Issued <br /> <br />Arrogel•Cts4 /••1•114.• .•%filti• on • I • nitirlet fOf•pa.rn't In c 1"4Cf TPo •rpi.eli tOort •••4,4• "PI' P40. <br /> <br />V(//1/ <br />- • <br />( 4C o% <br />; <br />•• .0.fl Co,rne,c;431.0 Trevii•• (..iourt 0Kt <br />Number of looters Lot size . . <br />,-- F) Private (2' Depth to Wetter Table A. r' <br />i G.A.Pol 0 Sandy Loam 0 Clay loans 0 Clay LI Adobe Ft Hardpan 0 <br />t.6 0. New Coettructlon: Yee. ai No 0 FHA VA Y. 0 No R <br />./ <br />Dice 40 ,11 fle.1 <br />NC. of com-ririr"'-' <br />D;ItAr.,:e frOry, <br />!JumbAr r•f <br />Ty r(' offlifft• r•,00.11 <br />0 ,ttence to nelrno <br />Number of pits <br />Dist A nco I.orn nnAto. <br />Sze: D;(1 ,71•01•1• <br />34.4.1rOCA /rComl r'o'oir ,•••• <br />DO1•45^lee to ,0 1,loo P I,o. <br />m mod el in to n / •nrisi inn (tiny- <br /> <br />(Plot plan. showing site of lot, location of sys't.m in relation to walk bindings, etc, can he placed on reverse tide). <br />(Signed) <br />°refits/mots. State laws. and rules end rt•iulAtions of tint San Joaquin; LOCal Health District. <br /> <br />I hereby certify that I have prepated this Application and that the work will be done in accordan c e with San JoiquiniCosanty <br />Syr. <br /> -X ti I. ' I ‘. <br /> <br />,r ,. , .. kt't J. I iY / <br /> <br />....:L=1:4a..:. (role) ;,..-,... . <br />i <br />.. (Owner and/or, Co4ractor) <br />t <br />r_‘wnor Nam* <br />JOB ADDRESS AND.Lk2ATI011 <br />r <br />Address <br />Contra:tot s Name .n. I. / <br />Installation will sore*: Residenr.• I <br />Numbest. of limier' unity / <br />Wats. Supptyt Public system (.1 <br />horrid« of soil te • depth of 3 feet: <br />Pre...vs Application Mad.: Ill yrs •4 ',". <br />'‘'nlic Tank: <br />D spout? F•eld : <br />SeepAg e P;t: <br />Cesspool: <br />r• yy: <br />TYPi OF INSTALLATION AND SPECIFICATIONS: <br />(No septic tank or cesspool perm ;Heel if public sewer is available within 200 feet.) <br />•••• ' <br />f. <br />Distance froris foundation /L. / .. Materia' <br />SO7. .2...X .3 %...s -.Liciu;d'depth .. ./0/./. Capacity....54.4..)..... <br />D.stance from foundation ye •t. Distance to ft0.1,451, lot line 41" / <br />Length of each line . c ' Width of frames 2.'....... <br />Depth of filter material f; '' Total length :3'0 i <br />Distance fr.ort foundation ...'i't ..... Distance to nAn ,nst lot in, 3r.o <br /> <br />Sire: Dirtn,etnr ....? ..t.* -.-- .. u.,,,,N :- ......! <br />Distance from foundation Lining material <br />Depth Liquid Capacity . gals. <br />Distance from nearest building <br />t... <br />r••,,, 3 /oa t; 4 ". <br />J. <br />i ./.4.