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OFFIC F I KF. FOR OFFICE USE: APPLICATION FOR SANITATION PErMIT f ` (Complete in Triplicate) Permit No.7 9."�g7�/ �. Oakdale Concrete• & Pipe Co. .. Yti f.7:) POST OFFICE BOX 13 Date 'Issued. .//-_7� This Permit Expires 1 Year From Date Issued ' DAKDALE, CALIFORNIA 95361 � �- in Local Health District for a permit to construct and install the work herein described. �rti� : n is ma e icn co�J� liance yith Cou ty Ordinance tJ 549 and existing Rules and Regulations: JOB ADDRESS%LOCATIONa$.z . .S!,Jc, ...TTr 1�4c...it44 f�� D f� /w....CENSUS TRACT f Jv e Owner's Name .. R _:.T��L1 s I,C_J _ Y 4 ..... ...... . . ...... ..... .. ..............Phoneg23!03 ii Address_J'.ly_ .Ze L_ $�A ... ......... .. Z3... Contractor's NameQlA?«ALs....Cf�F„) ..t�c.�1.77...........License i Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Court ❑ A . a l Motel ❑ Other. . ....... . h Number of liVng units:...... .......Number of bedrooms..Z......Garbage Grinder �v...Lot Size..ACd` 6c_ . _...,. Water Supply: Public System and name.............-_ ...... ....-.... .. ............ . ... ....Private Character of soil to a depth of 3 feet: Sand❑ Silt❑ Clay A Peat❑ Sandy Loam'[] Clay Loam ❑ Hardpan X Adobe [❑ ! Fill Material........... if yes,type r _ (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 `—' ��+ ( ppit permitted r ��611c sewer is available within 200 feet,) '. PACKAGE TREATMENT O SEPTIC TANK ( J. Size. ....... ... ).... ... ...... Liquid Depth :.....: _:........ ,C I:hhi - 1 � a;; �'� • Capacity..:..... '.::Type ....:.. Material.. :... ... . .... N,. Compartments_. .... Distance to nearest: Well.. Foundation .. .....Prop. Line.. ... LEACHING LINE pQ No. of Lines... . ......(. Length of each line ..:...`o..':........:.;:Total Length .: ....4de>.... . .. ..:.. . ..... cry . 'D' Box- ...Type Filter Materiol.NV4. Z!Ict�Depth Filter Material ..}.�r 'I.. . Q l.w+ Distance to nearest:.Well...... .yo.............Foundation.: :q Z Property Line... r it SEEPAGE PITK Depth..Z5.... .Diameter 3&.. Number I Rock Filled Yes X No 7 r Water Table Depth.' .. .. ......... ... ..Rock Size....._�./Z_.... .......... Distance to nearest: Well f.Z .,.. Foundation.....To. ......... Prop. Line .I .....: REPAIR/ADDITION (Prev.Sanitation Permit#.f W l`�Oz>a_�I.•>,_. .. r;)-ST,►4 -_-.,FE13--.-....1.1 Septic Tank (Specify Requirements) . . ... ........ . .. ...... ........ . : Disposal Feld (Specify Requirements)...AJ.D.......4 4?........0>`...�.><y... � t.Us` .._A0..J Z-13 .... .................7 . ... .._ . .................... ............. .__............. .................. --......I........................----.. ...._.. ....._--................................... ..._ . ... ...._......_: -- (Drow existing and required addition on reverse side) hereby certify that I have prepared this application and tKat the work will be done in accordance with San Joaquin County sOrdinances, State Laws, and Rules and Regulations of the San Joaquin Local Health District, Home owner or licensed agents ca signature certifies the following: "I certify that ' the performance of the work for which this permit is issued, I shall not employ any person in such mnnner as r� to becom lett Work s Co ensation laws of California." Signe _. 1 �u-e– �. ...._...Owner ...9pr.. ......CC%,.__.Title.:.f�1ArJA6M......59tiJrrAT�oA)...'TEAT (If other than owner) FOR DEP RTMENT USE ONLY APPLICATION ACCEPTED ... ........ DATE . . . . ..... . . . DIVISION OF LAND NUMBER ... .. . ... ....... . - - . DAIE ADDITIONAL COMMENTS...��1� r ... ...?.�. . ..°�..G.! ... c/-/ 7 ...�� P�� ..... _.. ..... . .. �U v........... ......... .. ...... _ .. .. _ .. .. .. .. .. . . .. -..... . . . ......... .. �,,. �.... r.. ................... . .. .. Final Inspection by: .. ...(/��'� >.� " Lt-<Lr^'.._r ......... ...Date :.. � .. ..� ' FH 3 24 SAN JOAQUIN LOCAL HEALTH DISTRICT Fas 21677 eev.7/76 3M