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;FOR OFFICP WEs Id, APPLICArdN'-ICOR SANITATION PERMIT 7�./y.. 4
<br /> Parmlt No. ....... ..
<br /> ........................................... ;(Complats in Trlplkaro)
<br /> Date issued -zl !1..: V t
<br /> f
<br /> ;t This Permlt Expires.1 Year from Date Issued
<br /> ..............
<br /> rict for a
<br /> rmit. to
<br /> and
<br /> l the
<br /> A lication is hereby anode to the Sun .loaawith Countyl Health Ordinance No. 549 and exl�sting Rules+and Regutat ons'sln
<br /> described. This application is made In compliance ,
<br /> �� �. ���(/'� ...........::....,.........• ..�:[ENSUS TRACT ...........................
<br /> !JOB ADDRESS/LOCATION ... _........ -
<br /> ,,COwner's Name ;E,•�... :Phone
<br /> - T : , . . +: _..Ca� y
<br /> ........
<br /> -- -•.....
<br /> Address ...� i
<br /> License-+ Phone� -
<br /> Controctorss-ItjaMe �` a £ f
<br /> mercial_ Trlle
<br /> or Court �]
<br /> Installation will serve: Resldance °Apartment-Housed Com C�
<br /> Motel,❑Ether.. ...................... ......... C. .`.,, =•-. ..
<br /> ` ' Index .. Lot Slxe
<br /> Number of living units:_... f P�iumber of roo s e •--• -, M v Q I
<br /> l 1 :.:L�ct/-. `..... .......... •�- '�:.�;,
<br /> Water Supplys Public System and Warne ... N
<br /> ' r-- � Peat Q Sandy Loan 0 day loam Q ( t O
<br /> Character of soil to a depth of 3 feet: Sand 0 Silt Q Clay Q
<br /> i Hardpah.C3\�Wo�s*-Fili-Materlal�:-:"-:::.If yes,hype........:. ... ............ j
<br /> i size of lot, location=o# system In`retatlon to wolfs, buildings, etc. must be places! an reverse side.
<br /> (Plot plan, showings r
<br /> ` e Pit rmittedif'public sewer is available within 200 feet,)
<br /> NEW INSTALLATION: (No septic tan_k or seepag p per E s .
<br /> � . liquid:De
<br /> SEPTIC TAN "'
<br /> PACKAGE TREATMENT SEPTIC ents . . ...
<br /> Capacity Type Material -- tNa. compartments .... - ,'.»
<br /> €. ,. ��,,,,,,,, ;. .Found6tio �'..f_'Prop. line . ....:.....
<br /> . . Distance to nearest: Well, .,r•�Y f k ��, .,•�
<br /> . Left- ch Iia •. Toto1, length l .,...;�•--
<br /> LEACHING LINE ' No. of Lines ..... .. I .. . ...
<br /> 'D' Box �/.'.,Type Fitter Material ..Depth Filter Material l ;:
<br /> V f '�„"�"� $�,_,. i P�opertl/ Line ..............i. ..
<br /> l Distance to ne ........ ..._. Foundation - ... ...
<br /> C arestr W811 .. _n ....� Y
<br /> ' , .pr Numba�,- f•. • •- =Bock Fi ed Ye:, � N
<br /> SEEPAGE PIT Depth Diameterf .. r•
<br /> Water Table Dooth. �,, ...................................Rock Size - ...:.... . _ . . . ii
<br /> ` '" .Foundation ., ` ..... Prop. no
<br /> ` Distance to nearestIlel! .. - t . . ..#.. .. .�
<br /> REPA1R/ADDITION(Prov. Sanitation Permit 5P '•-- ............................ Date ................... . ........ :. .
<br /> - } ..._..................... ,...
<br /> Septic Tank (Specify Requirements) -.. ..... ... _ ................ .......-----.......____..,.......... .. -; ......::....
<br /> }
<br /> Disposal Field (Specify Requirements). ._. .1................................ ......._......._ . ...._....... }.....
<br /> p +` .......�.°�............`_.. :,► ... ':: ........ .. . ........ .... . ..................... .€. _.
<br /> ....
<br /> „ •...........:........:.... reverse side)
<br /> ......................
<br /> -. 1. r
<br /> {Drav�existing.and_requlrecl addition ora_._Y _ �..-=. •
<br /> f i hereby certify that 1 have prepared this application and that the work will mob' -dons In accordance wish Sanoaquln
<br /> - "Cetrnty Orth ia- Staglaws,and...Rules-and-Regufations.of tits-.San Joagirin'lacahHaaHh Llistrkt,-Homs-owner ar lite*
<br /> sed agents signature certifies the followingON, � , sby l i sopa-litiuct�manner
<br /> - zed agent signature
<br /> in the peiformanca of wadi for which this permltis issued;1 sha11 not a+i►ploy any p
<br /> i as to become subject to Workman's Compensation laws of California." -
<br /> I
<br /> Signed ..,._... ... :.__..... owner /`t
<br /> - Title ...--.
<br /> PTiC"& SE�itlEfi SC
<br /> • RV10E�
<br /> BY - :_._ 263 So. Ora 4 Stockton, Cilit..`95205-
<br /> (if other than owner) / Pig.463-3209 1 Gor
<br /> ' FOR DEPARTMENT USE ONLY
<br /> TE APPLICATION,ACCEPTED .BYE:- ._...... .....
<br /> 8t11t•Dli+ -PRMI iSSUI+D ..............
<br /> .. t✓ ....
<br /> ADDITIONAL COMMENTS ' ..._......................... _..................._................
<br /> ..............................................:-_..i
<br /> - . --... . .......�?-.-v�. 7.............. _._........---•..............
<br /> . .. .
<br /> ...............
<br /> t -••........... . . _/.... .. .................
<br /> .
<br /> . ........ .......... Date .A; -,7. 7
<br /> Final Inspection by --•- ...................:.................. 8/7h 3M
<br /> EH 13 2h 1-68 Ro SAN JOAQUIN LOCAL HEALTH D15TR1CT
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