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I� FOR OFFICE USE: „ APPLICATION FOR SANITATION PERMIT Permit No. ___ -�:�7 7 ----------- - (Complete-in Triplicate) .�._r F � ----------I------"-------------------------------------- �� 3 � V< `V Dafe,lssued:_----:--`—;=!. Th'ss Permit Expires 1 Year From Date Issued A lication is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein de cribed. This application is made in compliance with County.Ordinance No. 549 and existing Rules and Regulations: JOB ADDRESS/LOCATION ------------- ---4-}--- ----- - ------------------------------CENSUS TRACT -------------------------- Owner's Name Bechthold & Peterson --------------------_-----------------t--------------- ---Phone 36_R-n5U0-- ------- ----------------------------------------------City --,._3Lodi------------------------ne 46-3 -.70-48 Address --------- �,��-_w'-.-'--'�.'QkB�.-- ----- -- - ' Contractor's Name $--a-ek- x—V s--Septi-e---Tank--Gd. License # --26g9-51 Phone " -..-- ---- Installation will serve: iq Residence"-4�.Apartment_Hou.seQ Commercial-❑TtailAt Court l❑ f Number of living units:__- Motel ❑Other __.---__--------------------- Number of bedrooms ----- Garbage Grinder --------_-- Lot Size ---_-. l------- -rp-!'-------- Water Supply: Public System and name-=--------------- ------------------------------------------------------- !, lay,- -__-Private ► Character of.soil to a depth of.3 feet: Sand'[I Silt®ii Clay ❑ Peat❑ Sandy 1Loarn ,� Clay Loam ❑ 1 (4 r s Hardpan ❑ Adobe_;]] Fill Material ------------ If yes,type --------------------------- q (Plot plan, showing size of lot, Iota#ion of system in relation to wells, buildings, etc.`must be placed .on reverse side.) + ,� k, NEW INSTALLATION: (No septic tank or seepage pit permitted, if public sewer ie bvaiIable within 200 feet,) tr e 1. SEPTIC TANK' Size----------- 4$X5 X�: �-- - PACKAGE TREATMENT [ ] ;-III- Liquid Depth a"----.------------- Capacity 1:21oa_,-_gaJT�pe ----sC} =' ------ Material---- �'O3' ar-e No. Compartments .....----- Distance to Nearest: Well -------5Q------------------------Foundation -------25---------- Prop. Line -------1�D_°-•--- LEACHING LINE :r.[ No. of Lines '---3:7 ---�' `Lengt"f each Iirre-- F�-�------- Total Length _-1-2-0-1----_---------- 'D' Box ---- ----- Type Filter Material ---------- ----- Depth Filter Material ----- �__;.-,:.......................... r. -.Li s Distance to nearest. Well ---._ 0--------------- Foundation ---10___--.--- ---- Property Line _100 ---°--.----- ., a ..�-.��..`..... f " SEEPAGE PIT ] Depth ---------25^- Diameter 3"_------_ssNumberl -✓- =ar--- ------------`: Rock Filled Yes No .❑ ! 2----v-------- Water Table Depth ---------9�-�- ---------------------------------Rock Size----- - t+ -------- , Distance to nearest: Well _--.--_- ~ 1`- +Qf .Foundation• ......... Prop: Line -------�'_------- y - r REPAIR/ADDITION(Prev. Sanitation Permit# ------------------ - Date --------------------f"- ? 120 0.'.. a1, _ _'ti _ . --- ------ ---------- I Septic Tank (Specify Requirements) - tank__,-- r- '.. Disposal Field (Specify Requirements) -------1.2.0�---LPA-Gh-,I� Tl --B�---3--Pits-±-25JfX °--------- i i I ------------------ l = --- ----------------r --- r I % ---------------- --------------------'-------------------------'-'-r--------i--------------'--' A {' t I 1 ^- ----------- -------------- -------------------- --------- --------------- ---._. ,(Draw existing1. a, required addition on.reverse side] I hereby certify that I have prepared this applicd?ion 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'Healthk13istrict. Rome owner or licen� f sed agents signature certifies the following: [ 1 I i :`I certify that in the performance of the work for which this permit is issuedr I shall not employ any person in such mi3nner as to%become subject to Workman's Compensation laws of California.'.4.` Signed � ----------- Owneer ) { -= ---------- (Ef_ other,than owner] FOR -DEPARTMENT USE ONLY GIr APPLICATION ACCEPTER' BY. ----------------------------------------- DATE: - t.. -' T DATE -'' BUILDING-PERMIT ISSUED_ . :--.._ -- _ _ -----. F ADDITIONAL COMMENTS ---------------------------- ------- ------------------.--------------------- .. ________________________________ __ ------------------/,/- SAN , :_____:_ ::__________ __ :__ _ ____ _______ _______ _ -------------- ------- - -- --- - -- - pate Final Inspection by:. -- =-- --L(�--- JOAQUIN LOCAL HEALTH DISTRICT E. H. 9 1-'68 Rev. 5M �` �"