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-- —MR MTV li APPLICATION FOR SANITATION PERMIT permit NO. �•�—�-'T G -.. tCentpleteln TripEkats) Date Essued":.-. � -77 .... ..................... _ _. - 9 Year Frown Date Issued _ This-Penult I;xplres r , .�,.,.•_ �- putrid- for a permit to construct and install,the work rk herein ; Applicatiorti is hereby made to the San Joaqutn`Local Heahh t .m_ _le . , described.,tltiarapplication�la made in tempi#grace with County Ordinance No. 549 and exlstlrtp Rules an �eg ..... ...... T10N .............. .... CENSUS T _. .... . JOBADDRESS/LOCA :4.. T��;"� ... ............. ... ..... ...... ... .............•--.................,. ...................................... Owners Name -. jeFPJ •.-• 1 City ..�. .......... ... .w.__................ .... Arl-11r4F A? Address .....r _- .6.4;...... . . ..._.....":............ .... . . •-..._.License #G .� .... Phone .. , Contractor's Name ...�•-��- 1 Residence Apartment House❑ Commercial 1]#raiter Court C] Installation will serves y 1 Motel[3 O! ... .......... _ her....................... � �- ��( Garbage ..._.....�Lot Size .. ............ .......... --- Number of living units:_:_1....... Number of bedrooms .... ......- I .-..N.. .. . .....................Private i Water Supply: Public System and name .................... .................... •"_' �y loom y ay Loam nWk . Sandr_1Silt Q -,Cldy "to�.. . Character.of soil-to-a,depth oft feet: r• . Hardpan Adobe❑ Fill Material ............If yew,type ....—MENNE --••• Me plan, showing size of lot, location of system In relation to- well;,buildings, 'etc. must be placed on reverse side.) No se tic tank or seepage pit permitted if,;public aewe r`is available within 700 feet,) + NEW INSTALLATION: ( p •-•- Liquid Depth .. .............. PACKAGE TREATMENT [j SEPTIC TANK{ ] � Si Aaterlat...... .........`...... No. Compartmentsi•--••,�j C.opacity� ....t: We ,...._.... F. 6 Foundation .................... 'Prop. Une ..6.6 ..�? ..---.- ^�, . Distance Yo nearest. ��- ;;i= -�--..- ---:, �.. n tfi Pq%2.................m Length of each }tne.'- Gs:•�• Total Leg 1 TEACHING LINE ( ] No. of lines ... ................. f ��,,y Depth .....MnMriai f !............ . .. 'D Box .3...... Type Filter Materia! I/ Filter :�o r..... ... Well .(,1 t : Foundation .l' ............ Property line Distance to nearest: ........ �t , •- Rock Filled Yes No {]�_ SEEPAGE PIT\J( I Deptl .c2�.......... Diameter ,„a :....... Number '.1 ............. ... .Rock j Water Table Depth ................................ ..... ....Rock:SiYe •* � ...._., t .Foundatlan '' - Line Distance to nearest: Well ..................... ................. ..,,.... . .........] station Permit ........................ ..... Date ......... ... REPAIR/ADDITION(prey. San .. .. 7 ................. ..............._.._.............. . Septic Tank`(Specify Requirements) .................... .................... .....,.......................... ................................ I Disposal Field (Specify Requirements) ............................. . ...... ......... ................ ...................................-..........._............ ..........)Draw existing and required addition on reverseside) t hereby certify that I have prepared-this application and that the work will be dere !n accordance with Sen Joaquin County Ordinances. State Laws, and Rules and Regulations of the San Joaquin total Health District. Horne owner or Ilcen• sed agents signature certifies the following: p an onion in such manner '°i certify that in the perFor '.nee-of the work for which this permit is issued, l shall not employ IP as to become sures} to rk n's C pens on laws of California." r //„ .......:.r'/ , .. ...................................... Owner ilgn ._ ..................... title ...._._............ - (If other than awned FOX DEPARTMENT USE ONLY DATE ... . .�8 . `�....:..:............: APPLICATION ACCEPTED Sy ._-- :... . .. ::..:....:....:....... ....._...... ..........:••••• ...DATE- .......... BUILDING PERMIT ISSUED ....... ADDITIONAL COMMENTS ...... •.........:......... ................................. . .................. ... ....................._....._....-_._.. .......Date Final Inspection by: ........... ••' 8/7h 3M , }{ 13 21a 1-6#3 Rov. 5K SAN JOAQUIN LOCAL WEALTH DISTRICT }