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........... <br /> FOR OFFICE APPLICATION FOR.SANITATION PERMIT No. .7,./ <br /> ........... <br /> .......I........................... (Camproto in Triplicate) 7-V <br /> Dote Issued . .....- i...;... <br /> .... .................. ........ 'all year From Dat*lsgu*d Z. <br /> •................. This PermitExpli <br /> poemit-to construct and install the work horein <br /> -of Health District for 0 t <br /> Application is hiereby made to the son Joaquin Loc 549 and-existing Rules and Regulations <br /> described. This application Is made in compliance with County ordinance NO. .I - <br /> ... 71 <br /> ........... ........CENSUS TRACT ................... ...... <br /> JOB ADDRESSAOCATION .-A .. <br /> ................. ....... <br /> on <br /> Owner's Name ........................ <br /> CI ..... <br /> ........................ <br /> Address <br /> ...)4L.- <br /> ense <br /> .1.......... .. .c <br /> Contractor's Name -... OTrallercouft:� 7 <br /> House fl Commercial <br /> installation will servei Res*Idence 0 Apartment H <br /> .......... ........ <br /> 'Motel 0 Other . ......... <br /> Number of bedrooms ............Garbage Grinder ............ Lot Size ...... <br /> .Number of living units:............ Num ..............private <br /> I —.._..._.......7.................... <br /> Water Supply: Public System and name ................................. ......... <br /> Sand m 0 Cloy Loom El <br /> ,It 0 Clay 0 .Peat 0 Y L0.0 <br /> Character of soil to a depth of 3 feet: ' Sand t3 <br /> If yes,type......••-:••••-......'-"' <br /> V!jAdobeo fill.M6.terial ............. <br /> reverse.side.) <br /> Must be. placea WU <br /> location of system In relation-ta wells,buildings, etc., <br /> —(Plot pion-show,ing—size Of A`i0t, ewer is�vollable within 100 feeM <br /> NEW INSTALLATION: (No septic t0nk or see ge pit permitted If fPubilc;s <br /> .pa- It I 'd t . <br /> 1 7........... -,Liquid Depth ...---•••••••••..77"' <br /> PACKAGE TREATMENT t3 SEPTI*C TAtfl I . Material.jai............ ........ No. Compartments ......7... <br /> Capacity ..... ............. Type....................... 8 .......... <br /> ounclott6h... ................. Prop. Lin, X <br /> a nearest: W411. ...;....................;-N�.......F <br /> Distance t Total Lino ......................... 0 <br /> is ... ..................... Length of-oiacfi'-line ............. <br /> •LEACHING LINE No. of Lin tot Material ............... <br /> oth,Fill ..................... <br /> Type Filter Material ...*.::..:....:......Depth' <br /> .......:.......Do <br /> V Box ........ Perry Line ..... <br /> Distance to nearest% Well ........................'Foundation .............".......... pro 0 <br /> ..................... Rock Filled Yes C3 bz <br /> SEEPAGE PIT Depth ........... Dicmetef• ............... Number .,: <br /> ...................... ....... <br /> Line ............ <br /> -.Rock Size ..... <br /> Water Table D'epth *.............. <br /> .............. prop. <br /> Distance to nearest: Well ................ ......................Foundation <br /> -Vale ..................I. <br /> ITION(pre4:Sanitatio• n Permit# ......... .................................. <br /> REPAIR/ADD an . ..... <br /> ....................7......•. <br /> ......................................... <br /> ...... ..... <br /> ......Fy <br /> Septic Tank (Specify Requirements) .................... <br /> d Requirements) ...... ............. <br /> Disposal Field (Rpecify . ...... ....... . .... .......... .............. <br /> ............. <br /> ...................:......�.w...... ....... <br /> ..................... <br /> C ................ ......................... <br /> . ........ .......................... ...................... ati reverse side) <br /> . .....-.......... (Draw-existing and required addition on accordance with Son Joaquin <br /> d that the work will be done In at licen. <br /> I hereby certify that I"-huv* Prepared this application on Local Health District.HOMO Owner Or <br /> County Ordinances, State Laws, and Rules and Regulations of the Son JoaquinI <br /> sod agents.signature certifies the following: such Manner <br /> ,I codify that in the performance Of the work for whish this permit is issued, Isholl."Ot 67"Play any,Pers'sn.in s c <br /> as to bocoMe subject to Workman's compensation laws Of COlIfOrisles-" <br /> Owner <br /> .. ... .. <br /> Sined ..... ..................................?41�1..............F <br /> V .... ................ .... . . ......... <br /> ........ Title <br /> than owner) <br /> Byg ......... j-o& <br /> FOR DEPAzIMENT USE ONLY DATE'... ./. '.. .._' ............. <br /> ................................ <br /> ........... <br /> APPLICATION ACCEPTED By .... .... . ............................ ................. . ... ....... <br /> ..........DATE -....Z. <br /> BUILDING PERMIT ISSUED ................................ '..:.........._._.y.--....,p._......I.......................................................... <br /> I A- . <br /> ADDITIONAL COMMENTS ....................... ....... .................................. ............• . <br /> ..................� ; . . ....................................:.................................. <br /> .. . ....................... ..........I................... ........... .............. <br /> ................ ........... .!............4.......... ...............................e....................._........:......... . ...... . ....... ...... ....I--. <br /> ........... .........................f. ...... ...... . .. .. .. . ... . ................. <br /> .................:....................... .....)CP....................... <br /> ....A............ ......................... . ....Dat <br /> nal Inspection by% .......... ........................ <br /> SAN JOAQUIN LOCAC HEALTH-DISTRICT <br /> 7/723 M <br /> 1 7 94 CAA <br />