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FOR OFFICE L)SE: r • .. ..--._-------...... ------ APPLICATION 6ORe SANIT .... ATiQN PERMIT 4Cotnplete in Tri licafei Permit No. .,-73-%7 ..................... This Permit Expires 1 Year From Date Issued Date Issued .1-2 �3" 73 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. F JOB ADDRESS/LO TION .-... ..- -_.•. ! � (/L c �y� Ow } ,. :.. j ✓1�....-... US TRACT Owner's Name •----..... / / ../ 2 Address _...- .. j - - ----- Phone -a....- .. L.L�I.....:-:-.-..... :_. . City TJ-C'�� .=•' f f•�s�Zd.� Contractor's Name ...:.......... ---- -.-...License # --- --=.---. Phone ...... .......... Installation will serve. Residence Apartment-House 0 Commercial oTraller Court [] Motel []Other - Number of living units:..... .,-.. - Number of bedrooms _. .._-Garbage Grinder ... - Lot Size Water Supply: Public System and name .. -�/ - ........ . ' L:.._.. .------�..-... ................P�ivote-❑ Character of soil to-a.depth of 3 feetSand 0 Silt❑ Cloy Pea #[� Sandy Loom [] Clay Loam ❑ I t Hardpan ❑ .f Adobe Fili Mcrteriai ------- .-.. If yes, type ._a.:.n.. ...........�_ ° {Plot plan, showing size of, lot, .location of system in relation to .wells, buildings, etc.. must be placed on reverse side.) NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) PACKAGE TREATMENT [ SEPTIC.TANK i Size--- _._._... Liquid Depth .--....: i 6 Capacity -_ Type --- --------- - aterial.._-...- ..,,----- No. Compartments -- --- .... T M -• ...0 I -Di'stanee'to nearest: Wella . .... _.•---------------------------Foundation ..... Prop. Line .--....----.-_.._ LEACHING LINE 9 �. r w [ ] No, of Lines - Length of each line..:.......... a-..._....,-- ,Total Len ih.. ....._.--•.------ 'D' Box ..:.. Tyne f=ilter Material •---------- ---:Depth Filter; Material Distance to nearest: Well -'Foundation1 - Property Line ---------------- SEEPAGE PIT biometer _-- Number Rock Filled Yes [] No ] Water.Table Depth ...... :..:.... Rock Size ..... .......... 37 Distance to nearest: Well ------ l �S.Z. . ......... ............ Foundatio :.., Pr __ i . REPAIR/ADDITION{Prev. Sanitation Permit •� �ne ' Date . :Z.3 -� j �p Septic Tank (Specify Requirements)).,.....' .. - e •- - ...... . Disposal Field' Specify RegAuir meats) !� O .- _- .-_. ........ .-- (Dra'w existing and required addition an reverse side) I hereby certify that I have prepared_ this application and that the work will be done i accordance 'th'Sain Jp in County Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local Health District. c e owner or liven k sed agents signature certifies.the following: "I certify that in the performance of the work for which this permit is issued, I shall not employ any person in such manner as to beco object to Work is C'm en..3r on la sof California." Signed . ...... Owner I By .. -. £ .. Title {If other t an owner) ......,-. .•. .....,. ........ OR PEPA 115E ONLY APPLICATION ACCEPTED BY . 'I. �. DATE ..I Z .. BUILDING PERMIT ISSUED .-.... ._ .. ..- . .._--- -------- ---- -- ---�.... .--. ��.-.7.�...--......-.. ADDIT NA COMMENT ------ ----------- -- - S .DATE ��a�� /� ��.uvz -- -x.15._..---_. - _��^---�- . � .._.. r Final Inspection b - - - ---Date --- ..-.. SAN JOAQUIN LOCAL HEALTH DISTRICT E. H. J,3 24 1268 Rev. 5M