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OR OFFICE USE: ±"""J`" <br /> APPLICATION I='�311+""S�NITATION PERMIT permit No. <br /> F ------------------------------------ <br /> -------------- - _ _....,_ [iC -- . <br /> __ . J= -ter. .. .r r <br /> A <br /> I --- .. - orn-lete in Tri licatel�•�_w�•�--.._._-_.._..r - <br /> ---------------- P Date issued -------------------- <br /> This Permit Expires 1 Year From Date Issued 3 <br /> l ----- - -------------------------------- <br /> . - <br /> - <br /> Application is hereby made #o the San 'Joaquin Local Health District for a per to'construct and install the work herein <br /> described. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: <br /> Lane— <br /> Y - CENSUS TRACT --------- -------=- <br /> JOB .ADDRESS/LOCATION-.-- c�C'xt��'_;�'u�]y & B��'31E�,� �3�e <br /> Jim McGees --------- ------------- ---------------- --..__Phone.-46-2!4150.----' <br /> Owner's Name -------------------------------- ' <br /> - -------••----- <br /> Address 322 ---F:'__ 'I: 11_. ----------------------------------------•--. City ----3 tim-.------- ---------- <br /> . r..i <br /> License # - Phone ---- --- - <br /> Contractor's Name -B��ckaY'k s--------------------------------------------------:----- <br /> 26��� <br /> Apartment House❑ Commercial :0Trailer Court i❑ <br /> Installation will serve: f f .1 i <br /> Motel F1Other ._-----A+ "s�"�----------- } �7 <br /> 100 Acres �i <br /> Number of living units:----1-- -- Number of bedrooms ____________Garbage Grinder ____-______ Lot Size ___------ <br /> Private <br /> Water Supply: Public System and:name ---- - - <br /> Char- cter.of§oil..to a-depth of 3 feet: x Sand-QSilt[E- Clay.,❑ ':Peat❑""Sandy Loam ]" Clay Loam ❑ <br /> H�ardpanJ Adobe'❑ Fill Material ------------ if yes,type -- -------------------------• <br /> I <br /> el•Is, buildings, etc. must be placed on reverse side.) <br /> (Plot plan, showing size of lot, location of system in relation to w <br /> NEW INSTALLATION; (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) <br /> I Liquid Depth __-_'�'----------- <br /> PACKAGE <br /> -- - --r.- <br /> PACKAGE TRE=ATMENT [� SEPTIC TANK'[ ] Size--------WX-5-'--X14 <br /> t <br /> Capacity -1229' Material----c__-----vn <br /> -e_ret'BNo. CompartmentsYy-} -.............. <br /> 4x-------- Type ----- ---_____ e <br /> ! f Foundation ____. -__ -- - --- p <br /> - <br /> Distance to nearest- W611. ---------- +- --------`- - <br /> 7Q_+__ Pro Line._-y�l-=.--- <br /> 2__---_-�'--`Length of each line.-_10.0 • i Total Length <br /> _ n" ) No. of Lines----- - <br /> LEi4CH1NG LINE � - .� �_ <br /> ` 'D' Box _-- - ---- Type Filter Material ---2"._----- -----Depth-Filter Material ---------1}- <br /> � -.-- Property Line <br /> Distance to nearest: Well _____ Fouridation _--- p tY <br /> ter. e�•�--- - ---- .-�'. <br /> ._ <br /> F.v e, Rock Filled Yes No,.Jp <br /> Diameter _----- -- Number ---2 <br /> SEEPAGE PIT ] Depth 25 i3 ... _ „ <br /> — Water Table Depth - ga Rock Sizet- <br /> ------------------ � . �. <br /> i <br /> i __Foundation ---,11�---�-- Prop. line <br /> t <br /> Distance to nearest- Well _______ _ - ----------- <br /> i I __ Date <br /> REPAIR./ADDITION(Prev. Sanitation Permit -------------------------------------- - <br /> 3 --------- <br /> 120{� - a} ----------------------------------------------- - - - <br /> Septic Tank {Specify Requirements} _-_----.- --- <br /> jra r z p ,1 -, --------------- <br /> D.is:posal Field (Specify Requirements) ------2.0-0-°---Lear-L1YXe__&---2-_�2)r�X�� P-1�.s-------------- �� <br /> -------------------------- <br /> 'P'��'— ____ ___-s_. _-___ <br /> _ _ wewp-nw� .+1�� <br /> (Draw exis {ng 5nd_requ{red addition an reverse side) <br /> YCv ry F <br /> I hereby certify.-that-1 have prepared"this application and that the work will be done in accordance with San Joaquin <br /> County Ordinances,State Laws, and Rules and Regulations of the San Joaquin Local Health District. Home ownerorlicen- <br /> sed agents signature certifies the following: <br /> "I certify that in the performance of the work for which this permit is issued, I shall not employ any person in such manner <br /> x� <br /> as to:become subject to Workman's Compensation laws of California." <br /> Signed ---- -- <br /> Owner <br /> - ---------------------------- <br /> -- ----- -- - -- --- <br /> Title <br /> BY <br /> (If other than owner) ' <br /> i,FOR-DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY _-- ---- - <br /> ' DATE ------------------ --------------- <br /> - ---DATE ---- -------- ----------------- ---------- <br /> BUILDING PERMIT ISSUED '-- ----------- -------------------•------------------------ -E--------- - ------ <br /> ------ <br /> -- - <br /> ------------- <br /> { //`r <br /> ADDITIONAL COMMENTS------- -- ------- - -_-- -- - ---- �� -- <br /> !" <br /> .-T <br /> L--- ---------------------------- <br /> 4-P <br /> ���s�---------f-----� - <br /> �. <br /> ^� tea^ -} @ <br /> --- - =---------------------------------------- -------- ���� ., �----�- - . _ ----Date ---�- ----- ------------------ <br /> Final Inspection b -----�- <br /> -------------------------- <br /> SAN JOAQUIN LOCAL HEALTH p?a '1C <br /> - r <br /> E. H. 9 1-'68 Rev. 5M <br />