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FOR OFFICE USE. ....... APPLICATION FOR SAWATioN PERm Permit No. .7 .................... Man plete In Triplicate) ....../ ............... Doti Issued ...... :.......••--.-................ ......................... This?9yrnit Expires I Year From Date issued Application is hereby made to the Son Joaquin Local HeAh-District for a permit to-constructlind -install the work herein described. This application is made in compliance with CounorQrldl nonce-Nc:.-5410 and existing Rules and Regulations: 1984 S. Drake JOB ADDRESS/LOCATION ....... ...................... . . .................._....................................... ................CENSUS TRACT .......................... Owner's Name ----- Jimmi-e-Wini�tiifi ...... ...... ....... '2 *...........*.................*......................Se r0ri..... ................................ Address ............... ;�835 E. Mi!n ..........:--------------------- .........m............ ................ City ........ ................................................ .................. Contractor's Name -------ROTO.-ROOTEIZ..SF-UER<_:SER........-----------_-------------License # 2.7.1539;......... Phone ..465-2616 1 . ............... Installation will serve- Residenceyo Apartment Housef3 Commercial oTraller Court 0 Motel E]Other__....................................... Number of living units:--L..__.... Number of bedrooms ....L....Gorbq9e Grinder Lot Size 80--by.-210..6....... Water Supply: Public System and name ...................... ....-.....--•-• I..........................;....Private Character of soil to a depth of 3 feet: SandL] Silto ClayO Peoto Sandy Loam.fl Clay Loam o Hardpan 0 Adobe E] Fill M6terlal A@....... if yes,type............ .. ............. n (Plot plan, showing size of lot, location of system in, relation to wells, buildings, etc, must be placed an reverse side.) NEW INSTALLATION: (No septic tank or seepage-pit-permitted If,publicseweris available within 200 feet,) PACKAGE TREATMENT13 SEPTIC TANK size.....4.Lty.. ............. Liquid Depth ................. 1200 pre cast concrete Ca pacity - . . Type ------ Material_............ ....... No. Compartments ..2............. Well a i 101 51 Distance to nearest: .....................Foundation ................ Prop. Line .......... LEACHING LINE (K) , No. of Lines Length-of each line...__8.5x'..._.8.5-'...... Total Length ...1.70.!_........... /V Box Type Filter Material rack....... ..Depth Filter Material .....1.8."......I......................... ::_. .. 10.1-. _1� 51 Distance to nearest. Well ........................ Foundation ........................ Property Line .................. SEEPAGEPIT -Depth .25...... Diameter aal'_...... Number __....... .2................. Rock Filled Yes ] No C1 Water Table Deptg ...*------108............................... 1�2 by ' -Rock Size --- --- 3 f_1---------- T Distance to nearest:Well ---_-nta............... ---._.._Foundation .__1_V.............. Prop. Line 5.............. REPAIR/ADDITIONIPrev. Sa,nitotioh.PermIt,# ......... ...............................Date ................ .................. Septic Tank (Specify Requirements) ------------------------------------------------ .................................. ............. .............. Disposal Field (Specify Requirementsi --------4........ ............................... ................. -------------- ............................. ------------ ----------------- ---------------- .............I........ .......................................... ............................................ .................................. ------------------ ----------------I.,---------------I----------------11--------------------___............................. ............. ...........•..-................. (Draw addition 6-nreverse sid's-) I hereby certify that I have prepared this application and that the work will :69 done In accordance with Son Joaquin County Ordinances, State Laws, and Rules and Regulations of the Son Joaquin LOW Health-Dishiet.'Home owner or licen• sed agents signature certifies the following: "I certify that In the perFormance of the work for which this permit is issued, I shall not employ any person In such manner as to become subject to Workman's Compensation laws of California." Signed -------------------------------- ,:k, --------------------------------------L------- Owner Contractor By -----------Joe" htL_than ---- __- --------------------------------------- Title :..............------------_----- --- - ------- ........0NeF owner FOR DEPARTMENT USE ONLY ED By ---0- APPLICATION ACCEPTED BY --- --- 3`7 --------------------------------------------------- U --------------- DATE,---..--,6 --------------------- BUILDING PERMIT ISSUED ... .. .... ----------- / DATE ..................•_-- -- ------------•----- ADDITIONAL COMMENTS ----------------- ---------I----------------------- .......... ..................------------------ ------ ........... --------------------------- ------------------ ----------------------- --------------------------_-- --------- ............................... .....................................____......... --------- ---------------- ............1--------------------------------------------I--------------------------I------------ ------- ------------ ----- .... ................ ------ ........ ------------ ........... Finalinspection_by:----- - --- ------ --------1-1------I-------11------- ----------------**----------------- -----------------I............. .......................... ......................Date EH 13 2h 1-68 Rev. 5M SAN JOAQUIN LOCAL HEALTH DISTRICT 8/74 3M