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FOR C31=FILE USi:: APPLICATION ICOR SANITATION PERMIT ........---•.....................•---.:...-•---------•-- . Permit No. .'�...��T .. _ F (Complete In Triplicate) _. . . _._. . ............ ....................... , ...........................,...:......................... This Permit Expires t Year From Date Issued Date Issued .........�_.�... Application is hereby made to the San Joaquin Local Health District for a permit to construct and Install"the work herein described. This application;pis made in compliance with County Ordinance No. 549 and existing Rules and Regulations- JOB ADDRESS/LOCATION ....., FremDnt............................... . ---........CENSUS TRACT ........................... Owner's Name Sunn*lan.d Fruit Cp. ......Phone ------------------ ...... Address ------------------------ -•--.-. ........................................ City Contractor's Name .RQ_t0_.AOo.te_ Sar. ............•___.•......----_..-..-._.........License #2-7-1-5,3,9---------- Phone _4.65_203.— ------ Installation will serve: Residence 0 Apartment House Commercial OTrailer Court 0 � Motel 0 Other----------------=--•---- ...._....._....... Number of living units:............. Number of bedrooms ............Garbage Grinder ......... Lot Size _................._------_-_---------- Water .......... ._-----_.-Water Supply: Public System and name ........................................................._....................................................Private [}. Character of soil too depth of 3 feet: Sand 0 Silt 0 Clay o Peat 0 Sandy Loam ❑ Clay Loam 1_7 -Hardpan 0 --Adobe-E] Fill Material .ao......If yes,type............... ............ � (Plot plan, showing size of lot, location of system In relation to wells, buildings, etc. must be placed on reverse side.) 1 NEW INSTALLATION: (No. septic tank or seepage pit permitted if public sewer is available within 200 feet,) PACKAGE TREATMENT [ ] SEPTIC TANK ] Size.......-L ..................................... Liquid Depth ........................... CapacityType.... :..... Material.............:........ No. Compartments ...................... .Distance to - Well nearest: } Foundation ----�-- - ----------•---t _.—Foundation y ................... Prop. Line ...................... LEACHING LINE j No. of.Lines ... ..............-------- ...y Length of each line.-- -- ..... Total Length .................. a. . ..De Depth .Filter Material D' 13ox -...'Type Filter Material � ' p Distance to nearest; Well ------------------------ Foundation ------------------------ Properly Line ......................- SEEPAGE PIT ( ] Depth --•----------_. .......4 [] (p ..__., Diameter ................ Number ..................... Rock Filled Yes No Water Table Depth ................... .............!..'.Roc Size • .:............. Distance to nearest: ..... .. .- ' .Foundation ------------- Well ..._.__ Prop. Line ...................... REPAIR/ADDITION(Prev. Sanitation Permit# � ) ....................... •---•----••---...--- Date ----••----------•-••--•-•• --- Septic Tank (Specify Re uirements }_... ........ t s•t 3... —16�� g a�ler rrI ...in----s-am ..... s o t as caved i n tank < Disposal Field (Specify Requirements) . ---........•--------------------------•---------------------•--•--•----•-•--------------•-• ------•-• •--•----------•-•-•---••-. ---------------------------------- ------------------------------------------------ ... .._ ..._.. ........................ -- ••••----------••------••-------=-------- (Draw existing and required addition on reverse side) 1 hereby certify that I have,prepared this application and that the work will be done In accordance with San Joaquin County Ordinances, State Laws, and Rules and Regulations-of the San Joaquin Local Heaith.Dlstdct. 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, 1 shall not employ any person in such manner as to become su (est to Workman's Compensation laws of California." R` Signed ----- - ---------- ---- - . ... •---•------------------------------•-•-•. Owner • Cpntractor - -----••---- -- -------- -Title ................................_.......... --.._.:.----•---- .......... f.other�wner) FOR DEPARTMENT USE ONLY APPLICA ON ACCEPTED BY - --- ------------------------------------- DATE -- ---- --- - ---;16.------.--- BUILDING PERMIT ISSUED --------- - -- -----------------------• _..DATE ----- - --------------------..-._....:.._.- ADDITIONALCOMMENT'S ---------------- •-----..--_ _...._.....--- _-------•.-.._....._..... --------------._...........---------------- -------------- ---- ' Final Ins ection b ------- EH --Date j- ..._......__ ...... E 113 2h 1--68 Rev. 'SM SAN JOAQUIN LOCAL HEALTH DISTRICT 8/7h D; 3M