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' F'iCk USS= ApjslICATION AOR SANITATION rrPermitNo. `.. .......... ... ... (complete in Tripticetel issued tM ....... •� . .......... t Year I:rem i?aM Issued Date �.4 .s ......., .. . _ This Permit Expires i ,...••.. herein ................. ' and install the work permit to construct ulations' made to the San Joaquin Local Health Distrl rd;nuance pNo• 549 and existing Rules and Rap Application is hereby compliance with County.O This application�is mode In comp CENSUS TRACT ............ .... .. . described. ................ x.. .Phone ...... .... ......... JOB ADDRESSAOCAT O. .. .. . ... ..... ...... ... ...... .. ....... ... ... .. . .... Owner's Name .......... ..'• ...... ...........City c .• a / ..:. 1... . .License Phone Address ....P ,.�,-„ �.s,4�.ei--, .. Contractor's Name��"'c��"`� Commercial OTralier Court 0 Residence 1%Apartment Hou fl installation will serve: Y . .. . .....,. ... .. ,t/ ....... . I Motel Q Other_ - ' .�. slumber of ro .�•-Garbo ee�C.ninder .-��-••• �Size ............. .........Private[] � Number of living units:_ --• �L��.....:G�.. �.. ._. .....-............. .... - - and name . .. m Clay Loam 1 : Public System Andy Loa {� L Water 5u.pp Y Silt❑ Clay ❑ Peat Q . Character of soil to a depth of 3 feet= Sand'(] yes ty� .........I.............. Hardpan© _ Adobe$ Fill Material .... .......if . . to wells, buildings, etc. must be placed on revue side n of stem in relation et (Plot plan, showing size of lot, location it rml"e� if Public sewer is available within 200 feet.) NEW INSTALLATION: (No septic tank or seepage Pit • -- ........ . . . .... liquid Depth ....................... SEPTIC TANK� ) Si a..... PACKAGE TREA'T'MENT 13 Material.................... . No. Compartments .................... Capacity .................... Type ............ ... ......Foundation •----...... ......... Prop. tine ......-............. r-._--. Distance to nearest: Well ...............................f a it ...... ...... Total Length LEACHING LINE q € . No. of Linea .... f - . Lbw eDe-Depth Filter Material ,! .......................c^� �..... `D` Box s- � '.._ Type Fitter Material p tins •••• --..... J. ., Foundation .. .. Property .. .. Distance to nearest: Well ❑ • , r-r r r N �................... Rack Filled Yes � No Depth ---..... Diameter ��` umber rf SEEPAGE PIT ;W ............... ..Rock Size .. -_.... .............. r . ----------�- Water Table Depth - C. ....... dation/Via............ Prop. tine ... ............... . Distance to nearest Well • .�-�•-Y-- .Poon REPAIR/ADDITION(Prev. Sanitation Permit# ........................................ . Date...... ..., . ........ ,..,••....... Septic Tank (Specify Requirements) ...ll................ ......................... .... ................. '`:�'4,.:. :1• Disposal field (Specify Req e e tsl ..`_ .. ...... .s .............. .................................... . ............................................ . .. - . ..f...._. ............. .... .........:...................................... _........._. .....I............................. ..................._........_.._............................. Draw existing and required addition on reverse side) ac I hereby certify that I have prepared this application and that the work will Le done to DtsbrdA Hunte wfth Son or 'it*' County Ordinances, Stat* Laws, and Rules and Regulations of the 3 R sed agents signature certifies the following: arson In sues+manR "I certify that in the performance of the work for which this permit is issued, I shall not empley any p as to become subject to Workman's Compensation laws of California.” Signed . .... .R............................. Owner ` -• f •• ,. . .Title ....... By T (if other than owner FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY. .. rel- ......... .......................................... DATE .........................DATE .-_-....... . . ...__......---....... BUILDING PERMIT ISSUED ADDITIONAL COMMENTS _._..........'._. �..._ . ...... .......... :...._ �.__..� .__ _ :.. Y �r" ..................................... . ......-•------- ._... . .................. ------G.......... ...I...._..........._............................ ....--.......................... .. .. ---------- Einal Inspection by: .......................... ...............................................Date .r7 ._ .....l. ................... �3 2� 2-68 �• SAN VAQU/N IWAI ANN DISMIL7 �� p