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VIJK UFFICE USE: <br />--------------------------------------------------------- <br /> ----------- - --------- ---------------------- WPLICATIM r POR� SANITATION PERMIT Permit No. <br />---------------------- ------- ......I--- --------- <br /> ----- <br /> - t ................. <br /> (Complete in Duplicate) <br /> This PermitEx'Pir e0 Date Issued ....................... <br /> Application is her I s I Year From Date Issued Z-Z--,D—to <br /> hereby made to the San Joaquin Local Healfb District fog a permit to construct and install the work he in described, <br /> This application is made ir��ompliance with County Ordinance"No. 549, <br /> JOB ADDRESS AN:�01C'AT'10"K M I— t> <br /> W <br /> ------ ...49F......mvS.'PHIK--- -----v..!�....... <br /> Owner's Name--------- Lj <br /> ------------------------------------ ---------------------------_.......... Phone. <br /> Address------- -Ir I <br /> -----i�------.......................... <br /> Contractor's ------------------- <br /> Name_...... -ME -- , T-cL.......S.EsU ; ------------------ <br /> ........... Phone..................��,j <br /> :--...--•----- <br /> Installation I;J-.Apartment House E]: Commercial 0 Trailer Court E] Motel El Other E] <br /> Installation will serve: <br /> Number of living units: -1.... Number of bedroom4s -d?—Numb baths I... Lot size ------ <br /> I f <br /> Water Supply: Public system E] Community system [D11�-�riyate ;;;'ODpth To Water Table t. <br /> Character of soil to eddpth of 3 feet. Sand ZYGravel [] Sandy Loam [Clay Loam <br /> El Clay 0 Adobe[I Hardpan ❑ <br /> Previous Application Made: aflf yes,date--------- ------- _^o gg�New Construction: Yes <br /> _No_0__FHA/_VA_:.Yes ❑ No m <br /> TYPE OF INSTALLATION AND SPECIFICATIONS.: <br /> 1;6ol,permiffed if pi�blic=sewer is available within 2_0'_ <br /> (No septic tank or ces; G­feef`)-' <br /> Septic;.a nk: <br /> Distance from'nea'resf well-.5 ---------------Mat rial <br /> well-. -----Distance from foundation----0 <br /> 'IT <br /> IK No. of compAfmlelilsl!).�__2----------------�iie3X!7-A---��__ .-Liquicl deap.th------- -----------------Capacity_.___._'8. <br /> 4f 4 �, 4 <br /> n' N L le I I�i� `i9n. I <br /> Disposal Field: Distance from ewest:w1eli-14-D D stance from foundat' ---Z__.Dis'fance to nearestAII, <br /> Number of -—------ Igo... <br /> -------Length of each line----- -____'-------_-.-Width of french------725----- <br /> ----------------- <br /> Type of filter material.R0_C4_1N_1_.D' ,6pfh of filter material....... 1�.....Total length-------- -------------------- <br /> Seepage Pit: Distance to nearest well------------�t----2t_.Disfance from foundation....................Distance to nearest lot line__....__.__._.... <br /> El Number of Pits----------------------Lining material-----------------------Size: Diameter------------------------Depth------------------ <br /> Cesspool: Distance from'ne'est well-------------.-Aistance from foundation--------------------Lining material..._-___-.__-______--._____..._..__._ <br /> ar <br /> 0 Size: Diameter----- ------------------------------ 6pf ------I------------------------------------------.-Liquid Capacity-----•-•-----•--------------gals.40, <br /> Privy: Distance from nearest well--- ------------------------------I--------------Distance from nearest building-------------------------------------------- <br /> F-1 Distance to nearesf..10 Jine---------- <br /> ----------------------- ----------------------------------------------------- --------m-------------------------------------------- <br /> l -- - <br /> Remodeling and/or repairing (describ ---------------------------------------------_----------------- <br /> 1 4.4 :41 <br /> ...................-------------------------------------------i-----------­----------------1�0 er <br /> -------------------------------------------------------------------------------_------------- <br /> ---------------------------------­-------­---------------------------------------------------------------- ------------------------------------------------------------------------------------------- <br /> -----------------------•------....-------------------..»_..---g----------------------------------•--------•---.f------------------------------------------------------I----------------------------------------------------- <br /> I hereb Ce NY that I have this application and fhd't the work will be done in accordance with San Joaquin County- . <br /> ordinances, S and r s .!r tions of the San Joaquin Local Health District. <br /> (Signed)- <br /> -- ---- ------------------ -------- ---__--_(Owner and/or Contractor) <br /> By-------------------------- <br /> --------- ----*----------------- -------------------------------------------------- -----------------------(Tifle)------------------------------- ------ ----------- <br /> (Plot plan, showing size of I location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY-------7_-!_R_,i9---i_-------------------------------------------------------------... DATE-----. _- ' <br /> REVIEWED <br /> ATE------- <br /> REVIEWEDBY---------------------------------------------------------------------------------------------- -_------------------- -------- DATE ------------------ <br /> BUILDING PERMIT ISSUED---------------------------------------------------------------------------------------------------- DATE. -------*------------------*------------*-------------- <br /> .............................. <br /> Alterations and/or recommendations:________-____.._-_. - <br /> --------- <br /> ----------:------ ------ --------------------------------------­­--------------------------------M------I------ <br /> --------------­-------- <br /> ..........--------------------------------------- ---- k......--------- --------------- ------- ---------------­-------------------*-----------------:-------------_-- <br /> ------------------I---------------------------------- - -- ------- ---------------- ----- -------------)---- --------------------------------------------------- _I------------------ <br /> _ - -------- <br /> ------------------------ --------- ...... ........ --- - --------­­­- ----- <br /> --------------------------------------------------------- - <br /> ...................... <br /> FINAL INSPECTIO BY- <br /> ---- -- Date--------- <br /> JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street <br /> 124 Sycamore S <br /> Stockton,California L*di,California Street 205 West 9th Street <br /> Manteca,California Tracy,California <br /> ES 9 REVISED 8.59 2M 5-62 ATLAS <br />