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v°67tYr "t.� ::: �•� F ''` "is�`^i�',t,: � J i,. y .. r ,•r. FOR OFFICE USE: FOR OFFICE USE �r APPLICATION FOR SANITATION PF.EMIT c, ................ . ... . ....... Permit No...74 ��✓-.. .. (Complete in Triplicate) Date Issued-. :_�— :� ..-_.. .. This Permit Expires 1 Year From Date Issued ..... Application is hereby made to the San Joaquin Local Heolth District for a permit to construct and gali the work herein described. This application is made in compliance with County Ordinance No.549 and existing Rules and Regululations: 1 ... � / 2 CENSUS..TRACT ...-.... - JOB ADDRESS/LOCA ION.- ,_ /—`w -.Gr.J �/ ,5_.,.-.. .,�..,L��/L�: C/� ...........Phone. - � � _/_ __ 1 . .... . ..... .. Owner'�s Name . ....C�..1C c:.C� :a = City.` T Addres]:....... ......]t}. L.. _ F, �yti License Contracos Name-. . C . .. .. .. ... Installationwili serve: ResidencegJ Apartment House El Comm ❑ Trailer Cot ❑ I i 1 Motel ❑ Other....... ............. . �G ( Garbage Grinder . .... Lot Size •--' { Numl of living units:...... ........Number of bedrooms 9 rival s . Water Supply: Public System and name...... Silt ClPeat❑ Sandy Loom ElClay Loam❑ ff Character of soil to a depth of 3 feet: Sand F-1 ❑ Y❑ (: ! erial_...........If yes,type.............. Hardpan X Adobe❑ Fill Mat showing size of lot, location of system in relation to wells, building (Plot plain, etc. must be placed on reverse sidA.l NEW INSTAV.ATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) w ( NT [ ] -•--_ ....::.Liquid D epth SEPTIC TANK Size...... .. CompamntsPACKGT EATMEMateial.. . ... No. l . ......TYPa...................... . Capacity ty.... ....... .. y ' ' Distance to nearest: Well.. .... . Foundation..... .................Prop.Po L,ne1:. fI Toa Le �r J LEACHING LINE [ ) No. of Lines-:............. ...... Length of each line ..-. . ... Total Length f 0) Depth Filter Material ..... 'D' Box........-...Type Filter Material .-. p Property Line r 1. 1 Distance to nearest:Well. ... .Foundation Rock Filled Yes❑ No❑ 1 .Number............ . . ...' SEEPAGE PIT [ J Depth ..... ........Diameter.. ..... ...-'---... . Rock Size Water Table Depth _... . ... ........ -•- -- 1 _ r o I oun n. :.... m -Distance to nearest:Well. F dello _._ ___ _.....:: -.—.• a,; Prop L REPAIR/,ADDITION (Prev. Sanitation Permit#�..._:__ _ Date. - t .... ... ............... ---•---- .. _. 1. r i Septic Tank'(Specify Requirements] Dis osdl Field (Specify Requirements]i.-........ - _ / p G Z ...... ......... /L. .. ='� j"' I (Draw and requiredaddition on reverse slde� i enK - _ ave re ored this application dnd that the work will be done lin acco tom owner of licinssd agunty I hereby certify that I h P__P .__.. Ordinances,'i State Laws, and Rules and Regulations of the San Joaquin Local- Health Dis►rict``i / non in orl as signature"certifies the following::` an a such•m that in the erformance.of'the work for which this pe It is issued, I shall not employ, Y P ,I certify, p to betaine 'subject to�LnL n s Compensation laws of Celifo Lia. r .. ' _... n - O ner cam. I_ Signed., : T,tI e By (If other than owner) i i OR DEPARTMENT USE ONLY s,..., .. _-- DATE APPLICATION ACCEPTED BY._ _. .. .. _ DIVISION O,F LAND NUMBER .t .. - t y ADDITIONAL COMMENTS.. .... ... ....... . . . ct. : •--•. - - .� to- �/ '�: .. ..... 7A . . ... .. ... —_- .... ... o .-..... 7 76 7M .. F8 7 NEV. / Final Inspection by:. SAN JOAQUIN CAL HEALTH DISTRICT h EH 13 4a