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FOR OFFICE USE: 4� i APPLICA10OR' SANITATION PERMIT vUw�. N � �l u ..... Permit No z te-id (Complete in Trip#icetel iT Date Issued ....,- Vs.................. This Permit Expires I Year From Date Issued �?: e Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: JOB ADDRESS/LOCATION 1i1} N.......Alice .......CENSUS TRACT ........ Owner's Name ............... Deltdeveloa . pmnt...GQ.........................................................Phone .................................... Address .-. ...........P.O. Box 7414 ....City .......'tockton ...... Contractor's Name -........Rod© Rci©te-r---sei-y•-•..................•.............License # •..27-1-5-39..... Phone ...4-65-2-61:6----'._ Installation will serve: Residence M Apartment House fl Commercial QTraller Court 0 Mote(o Other............................................ Number of living units:....1...... Number of bedrooms 3.........Garbage Grindo",s....... Lot Size ../C-",/< �................... Water Supply: Public System and name ................. ,alif.,..,._Wtx:.._..........................................Private❑ Character of soil to a depth of 3 feet: Sand b Silt 0 Clay ❑ Peat❑ Sandy loam 0 Clay loam Q .� Hardpan Q Adobe 0 Fill Material ..Q......if yes,type............... ............ (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse skle.) NEW INSTALLATION: (No septic tank or seepage pit permitted If public sewer Is available within 200 feet) PACKAGE TREATMENT [ J SEPTIC TANK{ Sin....La..'_...by..(.i....Jay..9.�.z- -. Liquid Depth .4.1g!................... Capacity 14 Ty ?..e..as t �M lal.concrete No. Compartments 2 50• mus .............. Distance to nearest: Well .............. .•..............Foundation ....jal........... Prop. Line ..5!............... LEACHING LINE f I No. of Lines .2......... 85 an 'Tbt 170 r ----._..... Length of each line............................ al length ...............----•--...... 'D' Box ..fie -- Type filter Material .ro ek........Depth Filter Material .......18.::.............................. Distance to nearest: Well .. 0!............. Foundation _1.0'............... Property Line ..5.!...............V SEEPAGE PIT [ Depth .2.......--•------• Diameter33............. Number ....2....._............... Rock Filled Yes No O Water Table Depth ....9p t.....................................Rock Size ..} ...b73.a............ Distance to nearest: Weil ... , . .!...;p. .............Foundation ...1Q.!.......... Prop. Line 5.!.................. REPAIR/ADDITION{Prey. Sanitation Permit# ........... •------------------------------ Date .................................. SepticTank (Specify Requirements) ----•------- ......-........................................................................................................................ DisposalField (Specify Requirements) •----•---.....--•--•.... ...........................................•--••---......-•-•---••------•--......_.......................... ---------------------•-•---------•-•----------•------ ............................................................................................................................................. ......................................................................................................................................................................................................... (Draw existing and required addition on reverse side) I hereby certify that I have prepared this application and that the work wiN be done In accordance with Sen Joaquin County Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local Health:District. Horne ewnor or 111cow sed agents signature certifies the following: "I certify that in the performance of the work fair which this permit Is Issued, I shelf not employ any person in such manner as to became subject to Workman's Compensation laws of California." Signed ------ --------------------------------•------•-------------------- ............................. Owner BYJoe White Contractor ------------------------•---------------.---------•------------•..------. Title ............. ------..-.....-- -••-•--- -- --- (If other than owner) R DEPARTMENT USE ONLY ' APPLICATION ACCEPTED BY . .. . .. . . . —.......*-- ...........,. ---.---- •--•-.---- ......... DATE ..7� .' ... -------------- BUILDINGPERMIT ISSUED ---- - •-- • . .......... -•............. . ....... •...-• -_.._ ..---•--..._•-----...,-----------DATE . ............----------------- ADDITIONAL COMMENTS ... . .... .... . ........ .. • ........•• - _..... _..._.._._.._.......... -------- ----------------------- - .......... ... ........-............................ ........----.. ........ -----............................. ................ --- --•----- --------------- ................----•--..............---............................................--•---... - ---•-------------------------------- ---•-- . ........ •...•--...--•- ................. ..---.....--------.......-..._..... .. ------ Final Inspection by: •. - Dote .. �:.1�1��.�------ EH .... ............ 13 21a 1-613 v SAN UOAQUIN LOCAL HEALTH DISTRICT 8/7h 3M