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FOR QFFICE USE: SANITATION PERMIT <br /> APPLICATION FOR <br /> .-_ Y r�ry (Complete in Tri li l 1 y`"Perm ifNo. .7/`__ 0�- <br /> ---- --Ns.---------- <br /> Date Issued _7J_--- <br /> __-_--____ --------I--__--------------- ------- This Permit Expires ! 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 Regulatidns: 1 <br /> 1 <br /> JOB ADDRESS/LOCATION ---------2067_ E.-JOth- 5-t.--p....... ------------ - -CENSUS TRACT --------------•-----.---- r <br /> Owner's Name Dolores Wedel-_----_-- - i -: 4647: ---- - <br /> ------- ---- - -- <br /> Phone 7075.---- <br /> Address 19.1-5--Oxford_-w .y __:_ _- __ -------------- :City _ tk_nK = <br /> Contractor's Name ---rE�Pay-Les" Sep'tie Wank Service '.License# 6 -.737--`�` 4Oh-o'ne 4-65!t579-5--------- <br /> 4 <br /> Installation will serve , ,ResidenceK] Apartment House❑ Commercial ❑Trailer Court ;❑ <br /> i Motel I-] Other _-- <br /> ------------------------------------- -- <br /> Number of living units:_ __1_--.- Number_of.bedrooms _---2__..Garbage Grinder . no Lot Size _bas-- X--- {O---------------- <br /> Calif. �Water -Service - �- Private <br /> Water Supply: Public System and name - ---------------------------------------(S --------------- --- ❑ <br /> Y <br /> Character of soil to a depth of 3 feet: Sand❑ Silt 1] Clay ❑ Peat❑ Sandy Loa m❑ Clay Loam ❑ ; <br /> Hardpan [X Adobe ® Fill Material ------------ If Yes, type ----- <br /> -------------------- <br /> t� (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side.) R <br /> � \t� i X <br /> '1 NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) <br /> "t PACKAGE-TREATMENT { ] SEPTIC TANK[ ] Siie---------------•-------------------------------- Liquid Depth -------------------------- <br /> "N <br /> Ca <br /> pacity ----- Type -------------------- Material---------------------- No. Compartments 1 *i Distance to nearest: Well -------------------------------- <br /> '---Foundation ----.----.------------ Prop. Line --------------I--------- <br /> LEACHING LINE - J I No. of Lines ------------------------ Length of each line---------------------------- Total Length <br /> -------------------------- <br /> `D11 <br /> ._-_--------_---__-_-----`D Box ------------ Type Filter Material --------------------Depth Filter Material -------------------- --------------- <br /> i <br /> - ---— ,.--- « ,. <br /> Distance to nearest: Well ------------------------ Fou dation .-____-------_ Prope'rty Line -----__._--_---_ -._-- <br /> SEEPAGE PIT [1/ Depth ---._25.---- ___ Diameter -----33"---- Number_-_ _2........A`-_s,_ Rock Filled Yes ® No 0 i <br /> 'a <br /> Rock Size e�1----- <br /> Water Table Depth ___-_-- -- ------I- <br /> ---------- <br /> Distance to nearest: Well --------------------__--_--_-__-.-_-_--Foundation Y-��---�_--_-_- Prop. Line y ---.._-_� . <br /> N REPAIR/ADDITION(PreAcinitation Permit# -------------------- ------------------------------------# <br /> --------------------�-- Date )` <br /> SepticTank (Specify Requirements) ------------------------------------------------------------- ------------------------------------------- - _­---------------­--------- <br /> Disposal-Field <br /> ---------------- -= ----- <br /> `� •-_ II <br /> Disposal`Field (Speci,fy Requirements) --------------------------------------------- ---------------------------------------------------- ---------------------------------- <br /> - _ , <br /> ti ----------------------------------------------------------- ------------------ ----- I <br /> Vs 1 4 -----'----- ------------------------------------------------ -- ---------------------------------- <br /> --------------- <br /> ---- ---------------'-a ----_5 -- - -.---------------._------------ ---------___-_--_--_- __ ------__----.------___----.---_.- <br /> (Draw existing and required addition on reverse side) 1 <br /> I hereby certify' that:! ha a prepared this application,and that the work--will-be-done-in-aec,orda a with San Joaquin <br /> County Ordinances, State°.Laws, and Rules and Regulations of the San:Joaquin Local Health District. Home owner or licen- <br /> sed agents signature certifies the following: # <br /> `' l certify that in the performance o tfie work for which this permit is issued, ail not employ any person in such manner <br /> as tombecome subject to Worknwft Come tion laws of California." <br /> Signed` , ---------------•---------- Owner <br /> t <br /> BY --- 15 - - --------- -- ---------- -Title __Owner--off. _"Pay�Le _'.----Septic--Tank Sery <br /> of er r owner) eery 0. Warthan I <br /> FOR DEPARTMENT USE ONLY Art <br /> U'`i .- DATE ! -- y -------- <br /> APPLICATION ACCEPTED BY __..- -_-__- F <br /> BUILDING PERMIT ISSUED --.-------- ----- ------. - -D T - ------------------ ------------------ <br /> ADDITIONAL COMMENT,S��r'C4 G' `t ----- - -------------Qtn] "v�-----�� s , j owr.1. VL <br /> ^- ` ---------- ------ �'--... `}al--�-"--we,-- t's---7--- � Q------.1��*1r9_�-G1 �LNJ?. tea-------------------------- - <br /> �rs 5s � n -------- -------------------------- -------------------- ------,. -------- <br /> -------------------- -------- - -------- ----- - --- ---- <br /> Final Inspecfi' n by: ---- Date - --------------- <br /> 10 �------ ---- <br /> ipt��w ------ ---- -- -------- = <br /> SAN JOA QUIN LOCAL HEALTH DISTRICT <br /> r N 0 1_'AA Ppv- 5M <br />