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FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT '�J F Wr (Complete in Triplicate) Permit No: 2___-__7 -------------------------------------------------- This Permit Expires 1Year From Date Issued Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: JOB ADDRESS/LOCATION ,---------8740_Na alt__Acres---RQa�iS�pckt.Q1_ ----CENSUS TRACT -------------- ------ - -- Owner's Name --------------- ------------------R.,H.---Wallis--------------- -----.-Phone ------ - ----- ------------ -------�-- - X31--4b16--------•- Address -----------------------------------------------8_74_0___W,. .7 _0- W,�11Ut Acrezx--RQ s3Cit Y --s-t-ockton Contractor's Name ------------Parris ---&--Sous----------------------------- ---------License #10_0521--------- Phone _-LI--66-96Q7.......... Installation will serve: ResidencejftApartment House,[] Commercial:[]Trailer Court ❑ Motel ❑ Other ------------------- ---------------------•--- Number of living units------------- Number of bedrooms ---3------Garbage Grinder -�e,�_-_ Lot Size ...Acre_____-_- • ------------------••--- Water Suppfy: Public System and name ----------------------------------------------------------------------- ------------------------------------------------------Privateer Character of soil to a depth of 3 feet. Sand'❑ Silt❑ Clay ❑ Peat❑ Sandy Loam ❑ Clay Loam:❑ - Hardpan ❑ Adobe-RgX Fill Material ------------if yes, type (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side.) �Q NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) �I PACKAGE TREATMENT (16C SEPTIC TANK[ ) Size--------1ZQQ-------1#;X9 -.-___ Liquid Depth - 1204 q p ��---��,�----,----- 0 Capacity Type ----cTE ' ----_ Material---C�23CreteNo. Compartments $ (2) Distance to nearest: Well -----105 ____ ____________Foundation -----101-------- t -----.------ LEACHING LINE [ ] No. of Lines Qne. -- Length of each line-------60---ft_.____-_ Total length ___{0-,------------------ 'D' -Box ------�_1-)Type Filter Material ---rOCk------Depth Filter Material ...1.9 -__ Distance to nearest: Well ------5. _�_______-_-_ Foundation _l -'--------------- Property Cine - ----------------- SEEPAGE PIT [ ] Depth -------------------- Diameter ---------------- Number ---------------------------- Rock filled Yes [INo C]Water Table Depth --- ----------- ------------- -------=-------- #tock Size ------- ------------ -----•---- Distance to nearest: Well ----------------------------------------Foundation -------------------- Prop. Line ------------------ AiR ACWT40N(Prev. Sanitation Permit# -------------------------------------------- pate -------------___--- 3211210=ft (Specify Requirements) -----------JET_..-Package-d--s-ewage__treatment--- Disposal Field (Specify Requirements) --_- 6-01-_-additional---drain - - ag ----------------------------------------- ----• - --- -w-.- ,- ----.r -. : (Draw existing and required addition on reverse side) I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local Health District. Home owner or licen- sed agents signature certifies the following: "I certify that in the performance of the work for which this permit is issued, I shall not employ any person in such manner as to become subject to Workman's Comp�en ation laws of California." Signed ------------------ Parr�sh ons ' Owner By ----- ----- ------ Title -------- � If oth r than owner) FOR DEPARTMENT USE ONLY a APPLICATION ACCEPTED BY BUILDING PERMIT ISSUED ------ ------------------------------- - -- ---------- ---------- ------------ --------- ---------� DATE ----�� -��p�°�'► - ------------- DATE ADDITIONAL COMMENTS --- �- ---------- -------- - - - ------------- ------- ------------------------------------------------------------------------------------------------------------------------ -- ------------------------------------------------ ---- ------------- ----------------------=--------------------------------------------------------------- ------------------------------------- - - -------------------- ----------------------- ---------- ----------- Final Inspection by: -- __--c. P ----------------------------Date -- a SAN JOAQUIN LOCAL HEALTH DISTRICT E. H. 9 1•'68 Rev. 5M