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FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT _ a ..................._.- ....._........-.._....------ P plicate) ....------ Permit No. ..'77-. ......-- (Complete in Tri r ............... . ............._... -T .-__...--,-_ This Permit Expires 1 Year From Date Issued Date Issued ._�............. r e � Application 's herebymade o the San J aquin Lo al Health District for a permit to construct and install the work herein described atio e i li with County Ordinance No. 549 and existing Rules and Regulations: mi. of 99 on N side of Bear Cree JOB Ab R S/L AT10 _..... _----------------- ----------- - •- ENSUS TRAGI' ......_... .- t Owner's Name C.s...Chil er.s..%.._Omega.-Gonst.---C_Q-•---•-- .......:................................Phone ------...3.19._.2782-•---- Address PaO...Ba 849.. Lodi..-Ca ---------- Ciiy�__... -------------------- ... ..-••---.. ........................... Contractor's Name ....D...A Parrish.-&..SOr�s_�.-- 1C:;---------------------License #2 .... Phone .466.4.07 Installation will serve: Residence (2 Apartment House[) Commercial [-]Trailer Court F] Motel ❑ Other ....... . • - ---- -------------------------- Number of living units:..(I).... Number of bedrooms ..3-------Garbage Grinder .-.._..... . Lot Size _J55__X---2 Ll,*.._f.t...__... Water Supply: Public System and name -.-•-.--.-----.-•................•-•I ...---...................................... ---••---- -----------Private ] ' Character of soil to a depth of 3 feet: Sand n Silt❑ Clay ❑ Peat❑ Sandy Loam X] Clay Loam Hardpan ❑ Adobe ❑ Fill Material ----- ...... If yes, type .......... .............:--- (Plot plan, showing size of lot, location of system in relation -to wells, buildings, etc. must be placed on reverse side.) i NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) ..... Li . PACKAGE TREATMENT ( ] SEPTIC TANK 0 t,i Size---5X8......................._....... Liquid Depth ----59":...... Capacity 1200, 94Type Precast. Materiol_-.�oncrete No. Compartments .__...2.............00 Distance to nearest: Well -7J._.fMe....................Foundation ...._._.-0_t......._ Prop. Line _..25.1..__----....� LEACHING LINE :k] No...of Lines A3)_.___._._Length of each, line_....... Q Vit:•.:.._ Total Length _24A!................ 'D' Box CON . Type Filter Material _t.Pst _r0.91Vepth Filter Material 19.................................. Distance to nearest:-'Well _$5.....------------- Foundation 20!--- ........... Property Line ...t,.10! SEEPAGE PIT [ ] Depth . ... ......... Diameter -_------------ Number ....._....... ........ stock Filled Yes ❑ No 0 Q % Water Table Depfh ----------1. ..-Rack Size .............° ........ • "1 Distance to nearest: Well ....-..."...............................Foundation ....... Prop. Line ...................... REPAIR/ADDITION(Prev. Sanitation Permit# ...__"...................................... Date ----------------------------------) t SepticTank (Specify Requirements) ------ �- ------------------ ----• . . ------..------......----•---•---.-...__....------•-------- .....---............- ------•--- --.._---- { Disposal Field (Specify Requirements) --- --------------------------------------- ......................-.:.._-------------------------------- ....... I ----------• -----------------------------*''-,- .. -- .-..._...-----..........-------------•------------ •......................... ...............-----........_..........•---....----------•------- ................I.... ..... .......... ...............".._......---.. ....---- -- -- ------------..... ------...... ......-- ---._...._... .._...--------•• -- ......... 4 (Draw existing and required addition on reverse side) I hereby certify that I have prepared this application and that the work will be done in accordance with Son Joaquin County Ordinances, State Laws, and Rules and Regulations of the San Joaquin local Health District. Home owner or liven- sed agents signature certifies the following: "I certify that in the performance of the work f hick this pea e mit is issued, I shall not employ any person in such manner as to become suble W rkm n's Co pens i laws of C fornia., Signed - .- ------ -- Owner I By .... . ... Miles._.A...-Parrish............. Pres..- ........ ... .. Title . ... ... .............:.... ......... (If other than owner) FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY .... = --- ... . ...•. --.. DATE ._... 1. 7- BUILDING PERMIT ISSUED ........................__--_----- . --- ------ -------- ". .....DATE .........:-------- I ADDITIONAL COMMENTS ........... ------------------_--:.._.._I.......------------- - --._.I...---- --- --•------------- • ---.-...--.--- • ....-- ..._.-_---I.....I --•--------------------•------..._..-...... ---- ----------- ��tt Final Inspection by: -..-.-.....""-- _e ....----•----------------------- ------.........------------•--...._.............Date ..... ..��,`. ...7 ... ............. SAN JOAQUIN LOCAL HEALTH DISTRICT i i 1- 14 13 241.'aa 12d v- SM _. : _ 712-3�r