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LFOR APPLICATION FORSANITATION PIERMITPermit No: ....7�.7y�`�'� . ......... (Complete in Triplicate) Date Issued/ .This Permit Expires i Year From Date Issued \ in i, and drein Application scribed. Thishapplicat on so the Son made in complionceiwith County Ordinance No. 549 and existing Rules tand hRegulations: 7/ ©© , 1-07 c J08 ADDRESS/LOCATIO 13-1 - ..J----.� ---w� ... E, CENSUS TRACT .--4�--- •....... i Owner's Name ........ LJ E��-Q L) ?Q.'. Address F - ...............:.. Phone -.... .�-tl-F� Y-----`5----�Sw��Qf1�_..R�-!��......city -- - --�-----..... - - .......... Phone ------- -----------•---•--..._ Contractor's Nome ..------ - � �-- - ------------------ ------------ -License # .--- ....e.` Installation will servei Residence partment House{] Commercial❑Traitor I 1 rt Q L Motel ❑Other........... ............ t er i /j Ldt Size -7- _.. ------+. y..J....._GtlfbO a Grinder � ,. � Number of living units:......... Number of bedrooms - 9 Water Supply: Public System and name ----------- t----------------- ---------- ................T Pr t Character of soil to a depth of 3 feet: Sand ElSllt.0 Clay ❑ Peat❑ Sandy Ldom 0 Clay Loam 1;? 1 a W y1AA// e ---------- , t > Hardpan dobe❑ Fill Material rYf�.-_. If yes;typ (Plot plan, showing size of lot; location of-sys em In' relation to wells, buildings, etc.1must be placed on reverse side.) Olt permitted if public sewer is available within 200 feet,) ON NEW INSTALLATION: (No septic tank or seeps �' pe P 7 PACKAGE TREATMENT [ ] SEPTIC TANK Size_ -L •--X---�� -- liquid Depth s. C-----------n-- yp %')��f}I..S Atm aterial 1�URT NO. Compartments ---- Tv" -- � , �-•. T e --- rr- f� - Prap. Lina ... .. istane to nearest: Welir..:, s---- `-:?--------Foundation ;.,-; 1 ' LEACHING LINE [✓J No. of Lines _ ------ Length of eacK�line i a_.�..-� Total LengthAe l�F �� ............. ��// TJ4 ., • 'D' Boxy Type Filter Material &.4 K ----Depth Filt�r Material .. ------ ---- T r -'-:.'- ft r 1��.. Property Line ....._... f { Distance nearest: Well - -."----- Foundati n '" C r s I SEEPAGE PIT [ Depth Diameter - �--Numbe ----r1`� --- R°ck Fill Yes` No C' i J ........Rock Size _�.. :..f..----Z ` Water Table Depth .-Aug0........................ 1p Ptop` Line ...... Distance to nearest: Well .....��P..._':�:---•.•-------•Foundation . . ........ . .... i { i iice�.`.'-"". _ _____t_....TF.,)Date :.-� '•'�.. -•----..'_ .V REPAIR/dDDITION(Prev. Sanitation Permit .. Septic Tank (Specify Requirements) --•-------------- --------------- --. -•- Disposal Field (Specify Requirements) ....................................................... --- "-"- •- :. ................ ------------------- d -addition- -n - rs - -- � - - ; , t (Draw existing and required addition on reverse side),,7-' � uln I hereby certify that I have prepared this application and that the work will be done In accordance with San Jea cen. County Ordinances,''State Laws, and Rules and Regulations of the San Joaquin Local Health Distriliven ct. Home owner or sed agents signature,certifies the following: permit is issued, I shall not employ airy Parson in such manner "I certify that i the p ermance of the work for which this p as to beta bj Id orkma s Pens on laws of California." Signed _.. ._. . -- . owner -- ---- - - - ., ... Title .................._....... ---- --- - (If other than owner) FOR DEPARTMENT USE ONLY -- t ��... _ DA __ - --m. APPLICATfON7 ACCEPTED BY ..... R.:F�..-_. _. __......_, ,.... --------------- 'DATE..:- - -------- BUILDING ----- I BUILDING PERMIT ISSUED ............ N� - -- ADD TAGNflL-C(O fJ E S- ..—- � �4/ lT= _. E15!..:.1 ..T.. - V.fCl LN - - - r • - .5zr t�lfks - - ` - - ' Final Inspect - Do .. SAN JOAQUIN LOCAL HEALTH DIES W$r1l"� As S)V6FVJnl 'B�FoRE PERM IT R-C>� i E. H. 9 1-'68 Rev. 5M