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4PAitCAT Oht FOtt SANRATiON P +RtT :..... ------- f t Gor"pf tte'in Triplicate} Permit No. 7 1-37 ..............• This Permit Expires 7 Year From Data Issued Application is hereby made to the San Joaquin local Health Di Date Issued described. This application•. cr. in compliance with County Ordinance permit to construct and install the work herein ADDRESS/i-OCgTI . 49- JOB No. 544 and existing Rules and fie 1.-i-zrr - gulatlons. Owner's Na - :-••----•--�•---• - -------- Address ----- `• CENSll5 TRACT 1� ..--•--• - . ••• Contractor's Na _ ,�_ City Phone _ Name _ .. - Ery r .c_ ............ I --------- -- ''Instaliatl 'A _- on will serve: - ? e_.Licen ......... se # � -Residence = _ Phone partment House Motel � t7 Commercial� i •---• ..................... ra ler Court fl - Number of Iivin ❑Other--------.......units:..------ Number of bedrooms __ --.-Garbage Grinder 1+Vater SuPP(Y: Public System and risme __•-__. - ...... Loi Size _•.-_-_ - .............. - -- Character of _�.-_.. - soil to a depth of 3 f .'-- ____-_ feet. Sand .._. ---- " ❑ Silt l] Cloy - Private ❑ Feat 0 Sandy Loam Hardpan[� at 0 Fill JUti ❑ Clay Loam l� aterial ._._ jPlot plan .If yes,type ----- . showing size of lot, location of system in NEW INSTALLATION: Y relation to wells, buildings, etc. must be placed on reverse s( Wo septic tank or see ( �PACKAGE TREATMENT a pit Permittedf public sewer is available within 2de;} SEPTIC TANK f tx}feet t - -•---• SaixJ'eCapacity - �t-� - Type l-�- -'- _.- Liquid - - t( uid Depth No.tane to nearest: Compartments --� -- ---- - ••--LEACHING CINE No. ofLines e - � --------FoundationDi ----- - C - - PrLine' D Box --- MLength of each line Total Length Type Filter ell C11 -;t~ ..__.. .to nearest: Well Depth Filter Material -. .. --- Foundation .......Depth ---•([ •-..._---••- Property ��neNumber U _ -••• RWater'Table Depth ock Filled yes Na fl ..---•-------------••- ----._Rock Size _ Distance to nearest: Well - - -' REPAIR/ADDITION(Prev. ------• - _ ( Sa .-••-•••-----• .Faundation _Sanitation-Permit Permit# ...-.----- Septic Tank -------------•-- ---- D -• -- p Line ------• -.•_•__..___. - - Pro � (Specify Requirements) .-_--- ate ------------------------------------------- ----} �. Disposal Field (Specify Requirements) -------------------------------------- �..__._. `- ---- ------- ----- ....- ------------------ (Draw existing and r -------------------- hereby certify that I havePrepared. re a equired addition on reverse side) p p red this and Rei u and that the work will be done in accordance Faunfy Ordinances, State laws, and Rules and Regrllations of the San ,roti uin 'ed agenh signature certifies the following: with San Joaquin i'I certify that in the performance of the warlc for which this permit is issu 9 Local Health District, Hama owner or tfcert- s becorne subject to Workman's Compensation lavers of ed, I shall not employ any person ler such manner Sed-_..__---------•_---- California." r ------- 11J - -- Owner (if other than owner -- , 1 , Title FOR DEPARTMENT USE ONLY 'PLICATIO�CCE�PTED BY �,__.iltDING P 3 ITION -------•-------------- . - ---------------- - - COMMENTS -------------------------- _..DATE ---------------------------------------------------• ---•-- - - - ------ - •--- ---------- ...... . - •-.. ATE:..._--.._ - ....... :._.. = - - -------•---------- --------- ................inspection ---------•------ -----------•- -- _-----_------- a --- -_------..._. p ction by_ ---••--•-•- - - ...._ - : ............ - - ---- -------- SAN Date • -- _ �-...............__-._------- I JOAQUIN L -` ---•� _. i .,• LOCAL HEALTH DISTRICT ., ._IV