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FOR-OFFICE USE: <br /> APPLICATION FOR SANITATION PERMIT <br /> ------ I <br /> -----T�-__:�-�.�•Y�---._�--_:::- � ..,�_�... t, <br /> _7 ---�--r- <br /> ' T(Complete in Triplicate) ._-�_---Permit No: <br /> ---------------------------------------------------- - <br /> ---------------------------------------------------------- This Permit Expires 1 Year From Date Issued Date Issued <br /> Application is hereby made to the San Joaquin'Local Health District for a permit to construct and install the work herein <br /> described. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: <br /> ' David' <br /> JOB ADDRESS/LOCATION . 3--------------'-------------------------------------------------------- - -------------- - --CENSUS TRACT -------------------------- <br /> Owner's Name ______._Ge_o_,_---Prato-------_ �.- <br /> ---------------------------- -----•- ------------------------- -------Phone --------x66.8.5550---•-•- <br /> Address . Sia City -S-tockton--- ------------------------------------------------ <br /> Blackard's <br /> Contractor's Name ------ ------------- ---------------------------------------------------------=- -----License # 26895 ------ Phone 4d1!77948 <br /> Installation will serve: 'Residence [ Apartment-House,2-Commerciah Trailer Court <br /> 1 Y <br /> r; Motel ❑Other <br /> Number of living units:------- Number of bedrooms+_2_______..Garbage Grinder ____ "`_ Lot Size ______20 Acres <br /> ---- -- --------------- <br /> Water Supply: Public System and.name_________________ ____ _ __ <br /> -------- ------------------------Private <br /> Character of soil to a depth of 3 feet: Sand'E] Silt 0 Clay -,E] Peat❑ Sandys oarn C]Clay Loam:❑ <br /> Hardpan E] Adobe.E Fill Material ------------ If yes, type ---- __ <br /> (Plot plan, showing size of lot, location of system in relation to ells, buildings, etc. must bel-placed on reverse side.) <br /> 1 <br /> NEW INSTALLATION: [No septic tank or seepage pit permitted if public sewer is available within 200 feet,) <br /> PACKAGE TREATMENT [ ] SEPTIC TANK: Size__4_4_X5!�1_0A-----------€-__-----_ Liquid# Depth .__11$!!. � <br /> ------------- <br /> Capacity ---32{}Gga3TYPe ----Sqj-------- Materiall-con-ere-te No. Compartments __2............... <br /> I <br /> Distance to nearest: Well -----------5-0-0 <br /> ---------- -0°------------------Foundation --------- Pro <br /> Prop. Line -:---_-• <br /> LEACHING LINE [11 No, of Lines _____ __________________ Length of each line---------1{}0_x._------ Total Length .:iap_v_-._________-_-- <br /> 'D' Box -------1.____ Type Filter Material -__ ti-------------Depth Filter Material ____, _g„-------.--------------......... <br /> Distance to nearest- Well ___5-0-1-------------- Foundation ------------1Q-' Property Line _____ °__5____5.5__5 <br /> SEEPAGE PIT JC] Depth 25-!.-- ---------- Diameter __ (f!_ ” <br /> -----_ Number ___-__------______________ Rock Filled Yes E] No ip <br /> Water Table Depth -------------90 1 = Rock Size 2------------------------- <br /> Distance <br /> f 'Distance to nearest: Well ----10_Q_'___---`"----- Foundation -----20'-------_ Prop. Line -----�'-----__-- . <br /> ) _5555 _,. ., . <br /> REPAIR/ADDITION.(Prev. Sanitation Permit 5# ---------------.-------------------J------ Date ------____------------------------_) <br /> Septic Tank (Sp'e'cify Requirements) ------------1200-_Gal.,___Tank---104° <br />