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FOR OFFICE U515 i APPLICATION FOR SANITATION PERMIT <br /> .......... .................. .......I................... Permit No. <br /> lComolololn TrIplicatel <br /> .......... ............ <br /> ............. ............................ <br /> I�flf 0 a c'u�nffo c�ae a 161�ct'07c; permit to construct install the work herein App �6rewmqaet <br /> described. This� '-firaticin is ' do in compliance with County,Ordinance No. 549 and x1sting Rules and Regulations: <br /> application mo <br /> J08 ADDRESSAOCATION 71c,/r.......632, �e, �.�77CENSIJS TRACT .......................... <br /> Owner's Naw.4 <br /> .......... . ............. .............. ..Phone ..................................... <br /> Address ......... <br /> ........ . ....................City ... ............ ......................... <br /> Contractor's Nam ... . . ......._A.Ulcen;e #&,i7".__A/_'Pho <br /> Installation will servo, Reslcloi6*Apartmont House E] Commercial railer Court- <br /> UT <br /> Lit's <br /> Motel[]Other...............Garbe <br /> ................. ....... <br /> J <br /> , -,.\, <br /> Number of livihg wits=....../..+NumbWof. bo*o?ms ... .....C76rba%e Grinder Lot Stio <br /> f i i -,;, . 0 1 <br /> Water Supply: PublioSystern and name ............................................Prlvatqla� <br /> A4-:.. .. . . <br /> Character, f soil to ia'dep-th off 3 feet: Sand it ;qpd Cl <br /> ' e- t(3 Clay E] P46 0 1.Sandy Lqa!k 1yay <br /> Eve - <br /> 1ril,lorcloan-0—Adobe-0 if Fos _VpW_ <br /> ............... ............ <br /> (Plot plan;:"showing size of lot, location of system in rotation to wells;-k buildings, etc. must be placed an reverse side <br /> NEW INSTA4 12N (No septic tank or seepage pit permitted If public-sower Wavoll6ble within 200 feet') <br /> PACKAGE TREATMENT f I SEPTICTANIK Size Liquid Depth -�X........ .......... <br /> 7'­�`**. .. ..... <br /> No. Compartments <br /> Capac <br /> Typo ;V <br /> Distance to nearest: Well' .'.., ....... <br /> 4V......................Foundation .............. Prop. Line <br /> A <br /> LgACHING LINE No. of Lines ..C;)y.............. Length of Anch line....:(10......... .... Total Length 1,e ..... ........ <br /> .0. Box . ./.... Type Filter Material ....Depth'Filter Material 119............. ..................... <br /> Distance to nearest, Well -Sr t. .... Foundation -/a_... .: ...iProperty Line V!9 .. ............ <br /> it MWMT Depth --/,/).......... Diameter e.k&.`�Number ........ ...... Rock Filled Yes No C3 , <br /> �/ � . Water Table Depth ...42 . • .......... ..................Rock Size .... ...... ............ <br /> ................... ...... Prop. Line ....4............... <br /> Distance to nearest, Well ..Fo�ndation <br /> RlEPAIRADDITION(Prov. Sanitation Permit# .............•...,•........._............--. Date................................... <br /> SepticTank (Specify Requlrementsl ...................................................••-•---•...-......................................................................... <br /> DisposalField (Specify Requrementsl ............................... ..................................................1.6............................................... <br /> .........................................................I......................................................I.......................................................... ...... <br /> ...........................................::`Draw <br /> ......... *..............*...................... ...... ............. ................ ....... <br /> (Draw existing and required addition an reverse side) <br /> 11 1 hereby certify that I have prepared this application and that the work will be done In accordance with Son Joaquin <br /> County Ordinances, State Laws, and Rules and Regulations of the Son Joaquin Local Health District. Home owner or licen- <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 /> as to become subject to Workman's Compensation laws of California." <br /> i <br /> Signed .... ... ......... .......... ................ Owner <br /> ......... ... <br /> Y ......... . .... . .. .... . ... ................ litle ...... . . ....................... <br /> Of other than owner) <br /> -ORAIEP ATACN'T US J ONLYo <br /> APPLICATION ACCEPTED /Vt000e... 11, DATE .1;Z-730.7,29...... <br /> BUILDINGPERMIT ISSUED ................................ ............................... . . .... ................DATE ..................................... <br /> kQDIT1ONAL_COMMENTS_._-_.__........................... <br /> ..................... . ..................... ......... <br /> .......... <br /> - <br /> ----­-------•-------------------------­­.........�<-�------------------------ ...... ........................... .................... ...... ......... <br /> ............ ......... <br /> ............................................................................................... .... .......................:................... ....... <br /> .. ..................... .... ........ <br /> in"a"I-In­'s'p­e­c*t'i o-i--- ..................... ............... .......Date .........I.............. <br /> EH 13 24 1-611 Rov. _ql SAN JOAQUIN LOCAL HEALTH DISTRICT 8/7h 3M <br />