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-,fJR OFFICE USE: APPLICATION FOR SANITATION PERMIT •----- Permit No. ..................... \' (Complete in Triplicate)�- ...........................:. �.... Date Issued .l-........�S .............................`: --._....---..-....----- This Permit Expires 1 Year from Date Issued ( 2�— c)eD --oq 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: JOB ADDRESS/LOCATION .....,McDonald Island --_Turner .Gut Station CENSUS TRACT ......................... Owner's Name Pacific Gas and Electric Company 466-2261 ................. . . ..... ............. ..... ................. Phone ..................... Address .............40.40_W.e.s.tLane.--- ...... -- ... ------......_.-..-•-- ------------ City _Stockton --- ---....... Pacific Gas and Electric Company 466=2261 Contractor's Name .. ... ..... .... ... . . . ................. . ----- --.License # ............... Phone ....... .......I........... Installation will serve: Residence ❑Apartment House C❑ Commercial ❑Trailer Court ❑ Motel ❑Other ......Gas.-Compressor-$tati on Number of living units:. Number of bedrooms ._..-_---.-Garbage Grinder .......... . Lot Size .................................... Water Supply: Public System and name .............................................................. ----------------------------------------------Private ZI Character of soil to a depth of 3 feet: Sand❑ Silt❑ Clay ❑ Peat[ Sandy Loam ❑ Clay Loam ❑ f Hardpan ❑ Adobe ❑ Fill Material YES....:,If yes, type ....Sandy..)oaln . (Plot plan, showing size of lot, location of system in relation to welts, buildings, etc. must be placed on reverse side.1� NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) PACKAGE TREATMENT [A SEPTIC TANK-f size--2--�_...,QQg, gallon_ ........... Liquid Depth ..........................^ Capacity . 24,00g.9at�p�pre_. . ....._ Marer;alconcrete __.. No. Compartments _..3.. �. Distance to nearest: Well 600... -------------------.•,Foundation ---- -- --- -I—— Prop. Line 704' LEACHING LINE [ ] No. of Lines 2 Length of each line .. -. - 45........ total Length _._90.`................... 'D' Box .. Type Filter. Material .Sj�,IlC�y.__IAsaillepth Filter Material _.._. . .`.................................. Distance to nearest: Well .._ MO.'__------- foundation -_.. -- Property line 120-1.__........ SEEPAGE PIT [ ] Depth _.__.._. Diameter ________________ Number .._........_ Rock Filled Yes I❑ No fl Water Table' Depth --- --------------.-------------._.---...........Rock Size ................................. Distance to nearest: Well ...-------------------------------------foundation _...:. Prop. Line ...................... REPAIR/ADDITION(Prev. Sanitation Permit# -------- -------- ---------------------- Date .....-----.----------------------..•1 Septic Tank (Specify Requirements) . . . ....... ----- ------------- . -• ------••---.............-----•-- --.............................. Disposal Field (Specify Requirements) ---------------- ------------ ------------------- -------------- - . ...... . -- ---_---_.._.- -.................. . ..... ...... ........ ... ..... -------- ... ....-- .........-...................... (Draw existing and required addition on reverse side) I hereby certify that I have prepared this application 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 Health District. Home owner or licen- sed agents signature certifies the following: "I certify that iab the perf once of the work for which this permit is issued, I shall not employ any person in such manner as to become, t to ,olrklma 's ompens ion laws of California." ......._• .._. Owner Signed Bytitle Supervisor of Land. Records. ...................................... ... • --------- -------- (If other than owner) R. W. STON O ARTMENT USE ONLY APPLICATION ACCEPTED BY ... .. . ------ -•--- -........ ... ............. DATE 77;;';.0..'-,7)---•---- BUILDING PERMIT ISSUED ...._.. - -- ---------------- - -- DATE ADDITIONAL COMMENTS , .......... .................. . ... .. ............. •-'.. .............. ............................................ ------ ----------------------- --------- _ --------- ............................-_....................._..--------- ------------------------------------- -- ....._. ..._._.-.........._-...----------- ....... .... . .................. ------•r --------------- ---------•• ...... --- . -- --- --- --------------------- :------ ..................... - .........-........ Final Inspection by: .. . ............ .................... Date .. = SAN OAQUIN LOCAL -HEALTH DISTRICT r E. Ii.. .�..2�►.1-'6 [.e M -...... _.... , - - 71723 ,.l_—