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1 a ' FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT �� 5= 6� ................:........�.._....._.............I - Permit No. (Complete in Triplicate) :...................,3-------- 7 ..................... This Permit(Expires I Year From Date Issued Date Issued ... ...... Application is hereby made to the Son Joaquin Local Health District for a permit to construct and install the work herein described. This application 1s made in compliance with County Ordinance No. 549 and existing Rules and Regulations: JOB ADDRESS/LOCATION ....1647. .Gi.lchrist..-............._.... ..----..CENSUS TRACT .......................... Owner's Name ...EJ.J.Qn:°"_HeffrQn..._... Phone . .�3 6. -7.2......._... -------------- .................... .._._....,_.....-•----•---..._.--_._ -- ' Address 1647 Gilchrist y 'Stockton .-.._...- - -------------------------------•- ----------- .....---..._.....-----...-.I---............---•-•------•--...._............. 't S Contractor's Name np&YsLe. .fit_..`dept .C..T�ttk8c_-SQW-er.--Serv.License#2.61.73.7--------.- Phone _42=5329......... Installation will serve: Residence X)Aliartment House-[] Commercial ❑Trailer Court 0 Motel ❑Other .................. - ----------------....._ Number of living units:..l;!._..,F Number of bedrooms ....2......Garbage Grinder ....no..-- Lot Size _.10-Q..X 0W.......... \ Water Supply: Public System and name _.Gal- ,f,--_Wet-Er•_S-exvC.Q..Cp..............................:.................Private ❑ Character of soil to a depth of 3 feet: Sand Silt❑ Clay [] Peat❑ Sandy Loam C) Clay loam ❑ �(1 Hardpan ❑ Adobe ® Fill Material ..... If yes, type ___......_.............. (Plot plan, showing size of lot-location of system in relation .to wells, buildings, etc. must be placed on reverse side.) NEVA INSTALLATION: (No septic tank or seepage pit .permitted if public sewer is available within 200 feet,} PACKAGE TREATMENT [ ) SEPTIC TANK I ] Size.-..-......... -------_....................... Liquid Depth ................... --...� Capacity .. Type Material.......... ... ...... No. Compartments \ Distance to nearest: Well ......a---------.------Foundation ---_---_.--..---..._ Prop. Line ....---•.............� LEACHING LINE Do No, of Lines 1 Length of each line.....40t................ Total Length .49.1..................... 'D' Box .31.0. .. Type Filter Materia! rOCk.........Depth Filter Material ._� S'f ......... .StJM Distance to nearest: Wel! _._ ?� _ _.._..._ Foundation ...10r_- Property Line .. i................1, k SPIN MDe th lot �' .x8tXl p :----... Diameter ..t..... . ..... Mmber . .-...-..1y.........:._ Rock Filled Yes [2g No Water Table Depth. .-.3Q....P11&9!...... ----------_----.-Rock Size _ 21Ito411.�__......_.. Distance to nearest: Well . '..rple .... ................Foundation - Prop. Line ...5�............. _. REPAIR/ADDITION IPrev. Sanitation Permit# .-__-....... .......... ....... .........._ Date ..................... ..._...-------) SepticTank (Specify Requirements) .............--........................................ .......... .......................-....................................... Disposal Field (Specify Requirements) 1-n-s a1ling..xiew_ZFO.° 't..:...o ._le.ach__plus...4.1.x8 x1_Q_1...r.o.ckt*. .fi l.erd. gp.ppage-pit...to_--take...the_-place...of--50 ft...--of _ ,each.-.that---goe. _.unc er...the house built next door to the South. ........ ... . ......... ..... .. .... . .. . ._... ---•---• --------------- ----- ........ (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. Horne 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 ct to Workman's pensatio laws of California." Signed _:. ... ------ -------------------- Owner BY . . . Title Contract-or., eo?w ®..$olne.r...of.__"Pay--Les' (If er the wner Septic Takk & Sewer Serv. R DEPARTMUff USE ONLY APPLICATION ACCEPTED BY -_ �. .. ... ....... ..... .. ........... -...._..._..... DATE ._... r.3_`7. .............. BUILDING PERMIT ISSUED ........... ............ ........I.... ......----- ---------.-- ..................... ...---........_DATE ..... ---............... ....- ADDITIONAL COMMENTS ___................ �.r - S _ ....... _- --- �s-f . .. .__:--::__ __._._:_::_: .....-•-----------• -- -- - ---- ------ . ----- - --- - - --..-_..... e Fmoi Inspection by: ----..... . .-•------------------------------bate ...... :. .7 ..........--- SAN JOA Q IN LOCAL HEALTH DISTRICT. i E. H. 13 241-'66 Rev. 5M