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FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT7-7_meq/ <br /> ...........................•--- <br /> Permit No. ...... <br /> ......... <br /> (Camplete irt�Tricate� <br /> ........................................... <br /> �� ". ©ate Issued <br /> This Perrn4,Expir s l Year From Date Issued <br /> io Q� <br /> App kation is ereby ma eto"th Snn Jociquln lacai Health District for a permit to construct and Install the work hefein <br /> described. This application Is made-•iii'compliance with County Ordinance No. 549 and existing Rules and Regulntionst <br /> ' �._ ACT <br /> JOB ADDRESS/LOCATI lu. ��e..... `'���.. (13� iVSUS TR :............ <br /> �...a .n,p�. <br /> iOwner's Name `.. f ... ... .............. ...........................Phone ............................--...... <br /> Address .1.�,.1-...- ; � �a1 {�,,� City ---- -m(t f !- <br /> ----- -... -•-•_ •-•--•---...- t --------.--.-...-�.-r Phone 9. -�D - <br /> Contractor's Name __---_•-t5)--4�-•>�J-E• " 6 <br /> fCf �Cori�mial Trailer Court ❑ <br /> Installation will serve: Residen a Apartment House 0 o _ 1 <br /> Motel ❑Other........ - U,12 <br /> Number of living units------------- Number of bedrooms ............Garbo a Grinder ..------:` Lot Size ` �Private L <br /> Garbage <br /> l Water Supply: Public System and name :-._:=•______________• <br /> .............. _ ��nd, <br /> -------- <br /> F <br /> ' Character of soil to a depth of 3 feet: Sand b Silt❑ Clay ❑ Peatoam ❑ Clay Loam j] <br /> Hardpan❑ Adobe 0 Fill Materlol ............ If yes,"type............... ............ <br /> { <br /> + (Piot plan, showing size of lot, location of system in relation to welts, buildings, etc. must be placed on reverse Sidi.. <br /> NEW INSTALLATION: {No septic tank or seepage pit permitted if public sewer is available within 200 feet,} / <br /> PACKAGE TREATMENT [ SEPTIC TANK[ I Size-------------_-........................ ...... Liquid Depth ----- _--? <br /> Capacity � �.. Ty.per �.Y1�rial-----.- ..... No. Compartments <br /> -"" <br /> k Distance to ne�arest: Wel J <br /> ..... ......_...Foundation r <br /> .1 ...__ .. Prop. Line .._.. .-- <br /> Len t of each neo' ,at �otal Length <br /> LEACHING LINE ( ] No. of Lines -..'.-;._.�...---A..-• g �j /����'-----�G� <br /> l D' Boxes-T e Filter Mater' > <br /> �. yp © B �r Material /�9' /r ........._, <br /> ' f --- Foundation d.:... ---Property <br /> Distance to nearest: 1Net.l_._,---•-•--•-••------- <br /> SEEPAGE PIT ] Depth ...................:`Diameter ................ Number ............................ Rock Filled Yea ❑ No C <br /> WaterTable Depth ....•......--............. .....................Rock Size .........••...................... <br /> - — <br /> Distance to nearest:. ell -----..Foundation .:.........:..... <br /> .._ fop. ne ................ ... <br /> REPAIR/ADDITION(Prev. Sanitation Permlt _=..-••--•-•----..•------------------••... Date .................................. <br /> ) fSeptic Tank (Specify Requirements) . ..... ........... ........................... <br /> Disposal Field (Specify Requirements)'-2,:...... ................ <br /> ---------------------•-•-------------------- ------..--..------•------------------- ----------- ------------------------------------------..----------------• -------- ......................... <br /> - -----------------d required a --------------• ----------------------- <br /> (Draw existing a <br /> ' <br /> --------------------------------------------------- <br /> - --------- - ---- - - -- . - nddition on reverse side) <br /> 1--hereby certify that I have.prepared this application and that the work will be done in attendance with San Joaquin <br /> County Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local Health District. Horne owner Or lit8n- <br /> sed agents signature certifies the following: <br /> F :"1 certify that in the performance of the work for which this permit Is issued, 1 shall-not employ any person In such manner <br /> as to h ome s j t #o W s mpe cation laws of California:" <br /> Signed . T `_. ............ Owner <br /> ----- Title ........ ............................... ........................... <br /> f Ilf other than owner) <br /> i NT USE ONLY <br /> 1 f -- ---•...- --•-•-- . ..--..-. DATE <br /> APPLICATION ACCEPTED. BY _--... . . .. _. %' ...- -. . _ -- - -- ----------- --- '� <br /> BUILDING PERMIT ISSUED --._... ------ --- - ----•-•--- • •.............DATE -.........--... .-..... :.. <br /> Ab© OMITS -...- . / --- - ......... ..... <br /> -. - ... <br /> IT a N" u r _ ----••-.._.-.--. <br /> Final Inspection b Date }T_.-"�.-• ... ....................... <br /> EH 13 24 1-68 Re AQU I.00AL HEALTH DISTRICT 8/7-h 3M <br />