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Ab <br /> S <br /> FOR OFFICE U c r;: pry,t; <br /> *"n�"CANON.,TOR "SANITATION PERMIT <br /> Permit No. <br /> {Com lets in Tr, locate} _ <br /> = Date Issued ��� , <br /> I ►� �,Ii This pPrmllExpires1`"Year Fr"em-Dole lssved <br /> s <br /> Application +s:hereby.madeto..theSon`Joaqu,n l� al"Heolth Distract fo"r a permit ro ;con tract ond',nstaIt the worfic 'hera in4.y <br /> descr,bed This appl,cation ,s made rn ompl,iancQ wdh County Ordinance No: 549 and 'existing Rules and Keg..r^+trons <br /> t JOB ADDRESS/LOCATION �� 3 �-�t .CC C'C �t-� CCt�15U5 ,TTtACT . £ <br /> hone m 4 h <br /> one Address <br /> � <br /> ContracJ 7 e <br /> �s <br /> Instnflat,on will serve Res,den e Apartment T-!ouse❑ Comr,erugl:QTra,ler Court <br /> N'otel other <br />} y �+ <br /> x <br /> Number of liv,ng units �t Number of-3�'dreici Garbage Grinder�C� `ot S,zP f d D«' ` <br /> / �t t 1 e�P�{' Pnvatrs <br /> S48 _- <br /> Water Supply fPub1 c System and home lY x � <br /> } s� ' <br /> Character of sail to a depth of 3 feet Sand 0 siilt G Clay �] Pent aardy Loam © Clay Loam Q _ j s <br /> e t > Hardpan G] 4dobe r,1!Moterial !f yes `ype t r3M <br /> [Plot pian showing size of Eat a 01 of sy tem in reiat,on to wells buildings etc mJ , b plated on everse,�sTde] <br /> ' �� e , { <br /> NEW INSTALLA31n*' �iJc sept, tpn orseepage pit permitted ,f pu❑ ,ewer,s available within 264 Feet► f z <br />` PACKS'' iRcr\iME[�T [ ] SEPTICTAN'C[ 14 <br /> z ',quid..Depth -- lw <br /> Capaaty TyrM Material <br /> No.'.Compartments. ; ; <br /> Du+ ice to nearest V`/e I Favndation' <br /> Prop Line <br /> LEACHING LINE No of Lones length of each.line Total Length . ' . <br /> D Boz , .: Type F,ltcr Material �P=' -.-Depth niter Material <br /> Distance to nearest Weil e�`C/ Found�tian /Q ?roperty Line <br /> SecrnvLDepth,c�s ..r D,anlete*" �i ".f Nurhbe R <br /> _� oc r' <br /> k Filled Yes N <br /> Depth ..... c`� Rock Size <br /> R stancep ul nearest: Nlell _..:.���::. Faundo ,on` ld. Prop Lf <br /> `} r <br /> = r ' <br /> REPAIR/ADDITION(Prov Sanitation Permit, � <br /> Date ! <br /> ` (Speafy Requ� cments] <br /> n � <br /> I)i sposal F1eld.(SpeGfy':;Requirementsl <br /> .'...i r"f..aT. <br /> ayS <br /> (Draw existing and required addition on reverse side( <br /> l 1 hereby certify that l have prep"ared this cipp!icalion and that the work will be done In accordance with San Jaartuln �. <br /> County Ordinances, State Laws, and Rules and Regulations of the Son-Joaqurn Locai Health District. Home owner ar ITcen . <br /> sed agents sigr.atere zartifies the..followmg R <br /> "'I certify that in.fhe performance of the-work for which this permit i•asued, I shall"not smplay any person in such rrtanner� ; <br /> ' •_ as to become su6lect to Workman's Cnmpensa'ran laws of California." <br /> Signed .. ...................... Owner <br /> k <br /> _... .. _. - .. ..--y-� <br /> G.ar-^c :-/V .. .. +L ._ Title' �C'+ !"YC�-[ CST <br /> -ilf other than awned <br /> FOR DVrART§AENT USE ONLY <br /> APPLICATION ACCE TED T3Y:. � �....:........ ..� DATE . ..`.—/ �! /l A <br /> ' BUILDING PERlJ!lT, IaSUE{1. -_.. . . DATE <br /> ....................:.... <br /> . ADDITIONAL COMMENTS. ................. <br /> , . _ <br /> . <br /> 4-t5-'fit..:. -- . .._ <br /> a .. � <br /> Final Inspection by: _ Lir..: '.._.... .......... . ..::.... ............ Dara ..� {. .... t om <br /> SAN J04QUIN -LOCAL HEALTH DISTRICT <br /> FE.H. 9 I-'68 'Rev. 5M <br /> r °2 <br /> 77777. <br /> Y- <br />