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s_—.'AOR OFFICE USE: APPLICATION FOR SANITATION P- MIT permNNo. .7�-�G.� (Complete in Triplicate) ......................................................... q -------••-------------------------------- This Permit Expires 1 Year From Date Issued Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to construct and Install the work herein described This a lication is made in compliainyce with County Ordinance No. 549-anted existing Rules and Regulations: JOB ADDRt LOCATION... . .L�2�rC+ fr� .( 47--..CENSUS TRACT .......................... Owner's Name /L/v�/ ./i! .� "'- -' ". .J'y _ �'•. d.- ..+.....................Phone .................................... Addressc%y/ .�%...... .... ... --- - City ........................_...... ............. .---------- .7 ....... . . .. ... Contractor's Name . :.GvL L:! -------'----...License # �. Phone �r f..��..�� Installation will serve: / / I Residence ❑Apartment House 0 Commercial 1�Traller Court Q Motel ❑Other ...,_....... -.............•--------•--- Number of living units:------------ Number of bedrooms ...........Garbage Grinder ............ Lot Size . ...��! Water Supply: Public System and name ... ..........................._W...................._• .............Private ❑ Character of soil to a depth of 3 feet: Sand 0 Silt❑ pay ❑ Peat❑ Sandy Loam ❑ Clay Loam J� Hardpan ❑ Adobe ❑ Fill M6terial ............ If yes, type ............... ............ (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 gvoilable within 200 feet,I PACKAGE TREATMENT SEPTIC NK Size. y y �� /y I ] i 7 -{`---� l` �.1...... ....... Liquid Depth .. .....1-...........- Capacity Z G.C...... Type tky- Material.. .... - No. Compartments > �........_...... r Distance to nearest: Well t----....-.--_-----_----Foundation. - ................ Prop. Line/1..r,`.............. LEACHING LINE [ J No. of Lines .14r-................. Length of each Iine.41y..:................. Total Length 0.2L................- 'D' Box A...... Type Filter Material / p YPDepth Filter Material .. ....................................' Distance to nearest: Well ........................ Foundation ........................ Property Line ......................k SEEPAGE PIT [ J Depth rj(..j 5...-... Diameter 1------------- Number _140.................... Rock Filled Yes Or No QZ Water Table Depth .......-.......................................Rock Size ................................ d Distance to nearest: Well .. /Fh........................Foundation .................... Prop. Line ..................... e REPAIR/ADOITION(Prev. Sanitation Permit# ............................................ Date ..................._............ J SepticTank (Specify Requirements) ..............._.................................................................-..................................._................. Disposal Field (Specify Requirements[ ...-•-......................_....................................-......_.................................................... .............................. ....................................................................................................................-•--•------------------•........_........... ............_._.....................-.................. .......... .......-----------------------------_..................................._...................................................... (Draw existing and required addition on reverse side) I hereby certify that 1 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 in the performance of the work for which this permit is issued, I shall not employ any person In such manner as to become subject to Workman's Compensation laws of California." Signed . - " Owner .. Title ....... __ _..-.. ._ ..._ - -. _.. pgoter - o Terl /FOR REEWIlLMENT USE ONLY APPLICATION ACCEPTED BY ._.. ...... ........ DATE - o --..... BUILDING PERMIT ISSUED . .. --- --.--- ' ---- .._ ' AT ... : .. .. . .. {.... . ADD( QMME3/�W,. -- ,.... M _. _._ . . vl]---. . . _.... . .. L ✓... .. -- - - - - r, Final Inspect on by: -.-.�. -. . .-. .SNYVM.-..a,ID/UC�..- - -- - - Date ... .-.1.:1..--_ .. ._........ EH 13 21, 1-68 Rev. 5M SAN JOAQUIN LOCAL H LTH DISTRICT 8/7h 3M