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r.. FCR OFFICE USE: . ; <br /> APPLICATION FOR SANITATION PERMIT <br /> E Permit No.Mompleto in Triplicatel <br /> Date Issued ----------------. <br /> .......:....................................... This Permit Expires 1 Year From Date Issued . <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and Install the work herein <br /> described. This application is made in compliance with County Ordinance No'. 549 and existing Rules and Regulotions:, <br /> JOB ADDRESSACICATION ...p�.--0. Box 30,,...Tracy, CA/Z4 00-•Schulte R. SUS TRACT ._...................... _ ~ <br /> Owner's Name Owens-Illinois, Inc. Phone 209-835-5---70-----1 <br /> ----- <br /> Address ._._..147Q9 SchulteRd..................--------------------------..-...--•-_..City .' x�Cy..,....� .-95,37 ..........--............... <br /> ... <br /> Contractor's Name Hallanger. Enginers, Inc'. 271, 541 415-254-4740 <br /> ---------------- ----•-- --- .........................................................License #` •-- Phone <br /> Installation will serve: Residence❑Apartment House f] Commercial❑Trailer Court i❑ <br /> Motel ❑Other.....1.UdUS_tX_y.................... <br /> Number of living units:............ Number of bedrooms -,-.........Garbage Grinder --__ ----•_- Lot Size '......:......:..........................: <br /> Water Supply: Public System and name ........................•--- ---..�.-_._..-...-------.._..:.... .........._.._...._............_:-..::....Private ❑ <br /> r--coni Sidon--1 O <br /> Character of soil to a depth of 3 feet: Sand 10 'Slt[2 Clay @ Peat❑ Sandy Loam 0. - Clay Loam ❑ <br /> Hardpan❑ Adobe Fill Material .-___.. .... If yes;type............... ............ <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side.) <br /> NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,[ <br /> PACKAGE TREATMENT [ SEPTIC TANK f ] Size................................................ Liquid Depth __._,___._.............._ <br /> Capacity .................... Type -•-•-•--------=----• Material...................... No. Compartments --------------:_..... <br /> Distance to nearest: Well ..............................______Foundation ...................... Prop. Line ......._.........._... <br /> LEACHING LINE [ No. of Lines ......_�$............. Length of each line....10.0................. Total Length ....4800.............. <br /> j <br /> 'D' Box ..... _____ Type Filter Material ::'l-2__-1/2_bepth .Filter Material Ap rox. 17" Total <br /> 1400 ftR ck 600 12 ...Be-]�ow ..,..-Vis..... <br /> Distance to nearest: Well•..-...-•_______________.Foundation ----_............._.._.. Property Line _.ifl! <br /> SEEPAGE PIT [ ) Depth ----_---------- ... Diameter ----------------- Number .....____........ .... Rock Filled Yes ❑ � <br /> NO- � <br /> Water Table Depth _..------•------------- ••••----•--•--•----Rock Size ... ------------------------ <br /> Distance to nearest: Well ........................................Foundation .................... Prop. Line ...................... <br /> REPAIR/ADDITION(Prev. Sanitation Permit+# ..--•--.--•---------=-----_-----------_-.. Date ____--_____- ...................... <br /> Septic Tank (Specify Requirements)..__. Utilise---exi ting__as is _-•.-.-- __-_- ----........... ...... <br /> Disposal Field (Specify Requirements[, Abiandon--- xs.jng-------Ins tall__new__and__larger__sys tem-_---____ <br /> (See attached design notes) <br /> ----------------- ----------------------------------- -•-­-----------------------------------------------.... -•--•......_••-•....__----.........._. ................................ <br /> (Draw existing and required addition on reverse side) <br /> I hereby certify that 1 have prepared this application and that the work will be done In accordance with San Joaquin <br /> County Ordinances, State Laws, and Rules and Regulations of the Sara Joaquin Local Health,District. Home owner or licen- <br /> sed agents signatu c ifies the following: <br /> "I certify that i e orm e o the work for which this permit is�issued, l shall not employ any person In such manner <br /> as to become ubi ama ' om• nsation laws of California." i <br /> - . <br /> Signed --- --- ----•------------------------------------ Owner <br /> r <br /> BY ------- ------- -- .. ._... -_.._. TitlE _. lt,tl��[!"': -L1,1R�4 �. .�-.� C—IA)E�� <br /> (!t other than owner! ` <br /> FO DEW!TMEM USE ONLY ` <br /> APPLICATION ACCEPTED BY --•--- ------------------ DATE <br /> BUILDING PERMIT ISSUED --- - ----------•- DATE ""------------- <br /> _-ADDITIONAL COMMENTS ........................ <br /> -------------------- ---•------------------------------ -------------• ----"- -------- ------ ....... --------------- � <br /> .............•---- - - -----------__"""-----------. ------ ----------------- -----------------•-•---------"-__""-"---- ------_--------------__--------------- -------- <br /> --------------- --- •----- - -•-----••••--•-•---------,"-----•--------� <br /> Final Inspection by: ... Date _. ------ ....... <br /> EH 13 24 1-68 llev. i <br /> SAN .iC►AQLIIN LOCAL HEALTH DISTRICT 8/74 3M � <br />