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i I FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT R_ (Complete in Triplicate) Permit.No- ------------------- V This Permit Expires 1 Year From Date Issued Date -------------------------------------------------------- f Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations. � 2545 E. Lovelace Rd. — Manteca JOB ADDRESS/LOCATION _____________________- ___.____ ___ ___ CENSUS TRACT i . Owner's Name Hayre t s Egg Producers 982--1155 ----- --- ---------------- -------------------------------------------------- ----- --------- ------..__Phone --- -------------------------------- 12565 S. Hiway 50 Lathro California 95330 Address City -- ---------- -------- - - ----- F -----------------.License #pf / Phone __ W Contractor's Name __ Installation will serve: Residence Airpartment House❑ Commercial:❑Trailer Court '❑ iMotel ❑Other -------------------------------------------- Number of living units:---- Number of bedrooms _'3_____Garbcge Grinder ___�J9 Lot Size -------�� -----,- Water Supply: Public System and name ---------------------------------•------------------------------------------------------------------- ------Private [ . i Character of soil to a depth of 3 feet: Sand!rV Silt❑ Clay ❑ Peat❑ Sandy Loam TV` Clay-Loam ❑ 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.) NEW INSTALLATION: (No septic tank or seepage pit permitted-if.Public sewer is available within 200 feet,) PACKAGE TREATMENT [ I SEPTIC TANK . Size------- d9a-.. -" ---.-- Liquid Depth ....♦y__________________ s ' Capacity ---------------- -- Type -------------------- Material---------------------- No. Compartments Distance to nearest: Well -----A,-S�A/--------------Foundation ____ �_______ Prop. Line �y► ' Q ' LEACHING LINE [ ] No. of Lines ______�_________.__ Length of each line /_ __.____ Total Length_ ------AS-77_____._. D' Box "___ ____ Type Filter Material Filter Material Distance to nearest: Well -- /_________ Foundation ------=?0_f______ Proper Line _____ I SEEPAGE PET [ ] Depth ---------------- Diameter ________________ Number --------------------- -_ Rock Filled Yes ❑ No .O Water Table Depth --------- ----------------------- ------------Rock Size -------------------------------- Distance to nearest: Well ----------------------------------------Foundation -------------------- Prop. Line -.------------------_. REPAIR/ADDITION(Prev. Sanitation Permit# _._----_---_--_---------_ -------------- Date __________________________________I Septic Tank (Specify Requirements) -- - -------------- --------------------------------------------------------------- --------------_-.---------------------------- Disposal Field (Specify Regyirements) --------------------------------------------------------------------------------------------------------------------- --------------- --------------- ----------------------------------- ----- -------------------------------- --------------------------------------------- ----------------------- ---- -- --------- - ---- -- ------- ------ -------------------- ------------ .(DraW'6xisfing 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. 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 z bieKt o rk s Compensation laws of California." Signe ------------------- ------------------------ w rier By - --------------------------- -- ---- Title -------------------- ------------------------------- ----------------------------- (If other than owner) FOR DEP TMENT USE ONLY APPLICATION ACC -- ACCEPTED BY --___-- - -�' : --- _.-------------__ __ -� �------- DATEr K; BUILDING PERMIT ISSUED --------------------------------- ----DATE ------------------------------------------- ADDITIONAL -------------------------------- - - ADDITIONALCQMMENTS -------------------------------------------:-- -----------------...----------------------------------------------------- --------=----- ----- --------------- ------------------- -- ----------------------- � G-�_ --------------------------------------- -- --- --------------------------- -------------------------------------------------------=------- Final Inspection b __._Date -------------------------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT I E. H. 9 1-'68 Rev. 5M y 4