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FOR OFFICE USE., APPLICATION FOR SANITATION PERMIT <br /> ............. ....... ...... ............ Permit No. 315 <br /> lComplete In Triplicate) ............... <br /> ..........I.......................I...................... <br /> ....... ................M................I...... This Permit Expires I Year from Date Issued Data Issued .................... <br /> Application Is,hereby thade-to the San Joaquin-Local Health District for a permit to construct and Install the work heroin <br /> described.,This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations, <br /> 134 N' el Mar <br /> JOB ADDRESS/LOCATION -an d..We-b er...... ................CENSUS TRACT ........................... <br /> Owner's Name _.....G.........M.- W_i-­-n----c­-hell .A., <br /> .r...d..,...S...o..n...s. <br /> .............--•---..................._._..:--... ........;....Phone .................................... <br /> Address - P- 352.---Main ... . .................... <br /> --- -- ...... ...................I......-... <br /> City ........... .........—.............__--------------------------------- <br /> Contractor'.s No/me <br /> 465-2616 aat.o___Ro_d_ter... # -2.71-539-------. Phone .............................. <br /> -installation will serve: ResidenceU Apartnent Rouse 0 Commercial.0traller Court 0 <br /> 1 Motel 0 Other..................:.......•----............ ' 153 X 115 <br /> Number of living units— Number of bedrooms ... ......Garbage Grinder ... esLot Size...... ............. .............................. <br /> W&tp 4i�_r...... Private Water Supply. Public System and name ---------alful�l -----­----------------------*­ ...... <br /> Character of soil to a depth of 3 feet: Sand L] Silt 0 Clay 0 Peat '.-Sandy Loom ❑ Clay Loom 0 <br /> Hardpan C] Adobe a) Fill M4terial ...zLo...If yes,type................ .......... <br /> (Plot plan, showing size of lot, location of system In relation to wells, buildings, etc. must be placed on reverse side.) <br /> NEW INSTALLATION: (No septic tank or-seepage-spit permitted if public sewer is available within 200 feet,) <br /> Ucl <br /> PACKAGE TREATMENT S.SEPTIC TANK ii�ze__-- --- Zz�K.__­- <br /> _ .-- uid-Depth_..4L............. <br /> C 120 pre cast 2 <br /> Capacity ------ ......... Type ...... r a ..........-•-•--•---.-No,Compartments ...................... <br /> see To t7e�_- <br /> 101 i <br /> Distance to nearest: ------_--Foundation ...................... Prop. tine 27................. <br /> LEACHING LINE, W No. of Lines ------ ....... Length of each line .............. Total Length .....I-Go-i..............Z <br /> V Boxrl 9......... Type Filter Material ...r-9 4-_ _Depth Filter Material ____._.-•..................... <br /> .....n../a....... 101 51 <br /> Distance-to nearest: We .... ­­ Foundation ...... ......... ....... Property Line .........I.............. <br /> SEEPAGE PIT, Depth ...25_t----...... Diameter _3.6� ....- Number ._--.-.----I-------------- Rock Filled Yes No <br /> Water Table Depth .1W.".........I 2_0....................Rock Size ..:lin_.bY._.3........ <br /> 1 <br /> Distance to nearest: Well --------h- ...../a.........................foundation .....0...., <br /> ........... Prop. Line ....... .............. <br /> REPAIR/ADDITION(Prev.. Sanitation Permit ...........----------------------•-- Owe ---------------•.......--------- • <br /> Septic Tank (Specify`Requirements). __Ap.K..�k_ank to be del6ted if the �existin&_16.pQ�.,g <br /> ­­.............................. .......................... ....1—.......... _@:I...g gLaq P e t'� <br /> Disposal Field .(Specify Requirements) ----pre.ca'.st­c an....... ..... .........be---ma.tche.d."-t o..this s....stub. . - ...elevation. . . ............. <br /> ..... . .... .. ........ . .... .. ......... ..... . <br /> -------------­-­­­-------------------------------------- .......................__­­............ --------------------- ..............I................................... ................ <br /> ------------- ...................I----------------­-----------1.1------------------------........ .........................................*............**.......................................... <br /> (Draw existing and required addition on reverse side) <br /> I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin <br /> County Ordinances, State Laws, and Rules and Regulations of the Son Joaquin Local Health:District. Home owner or licen- <br /> sed agents signature certifies the following: <br /> "I certify that in the performance of the work for which this permit-is4ssuedr.I shall not employ any person In such manner <br /> as to become subject to Workman's Compensation laws:of California." <br /> Signed --------- -- - ------- --- <br /> - Owner <br /> - - . Contractor <br /> ontrac..tor <br /> By --_------------- " .:- Title <br /> I otherthAnown;; .. <br /> ...... ....... ............... <br /> *ARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY _ . <br /> ....... ------- - -- -------------- ----------- --------------- DATE .. ............... <br /> BUILDING PERMITASSUED ........... .... -------- <br /> ADDITIONAL COMMENTS ------ ... . . ........ .... <br /> -- --- -------- ------------ -- - -------- ----------------- ..................J................................ ............... <br /> ---------- k <br /> ------ ----Z__7 7---------- <br /> .. .... .........t4/- ------ ............... ................... ..... <br /> -------------- ------------------ <br /> - ---------- -e------------------------ ------------------------------------------- ---------- ...... <br /> Final Inspection by: ------- ------- 1 -�4 -/ ----------- <br /> - -------------------------------- ...... ------------------ ------------ ...Date ..... ....... <br /> ----------- <br /> EH 13 2h 1-68 10- SAN JOAQUIN LOCAL HEALTH DISTRICT 7h 3M <br />