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FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT --• (Cem'pleo In Triplitote) Permit No...7. +�. . ......................................................... This Permit Expires s 1 Year From Date Date Issued 4t7:.;. Issued r 73 /V Application is hereby mode to the San Joaquin Local Health District for a permit to construct and install the work herein described.This application Is mode in compliance with County Ordinance No.549 and existing Rules and Regulatiomt JOB ADDRESS/LOCATION W Yt/CS.".6... N.1......... .......................CONSUS TRACT._._...__..._._..... VECKGi �nr�e t _. ....._.._S - Z& Owner's Name _fC �lrE i._...... ...... ............ ...................................Phore Address..................._......... ¢ ............-City 17XA "f........_......... PoeContractorC �__ ......Llcense# � ..L�'�� . ------------- Apartment Hous]Commercial[Tiler Curt IInstallation will serve: Residence Motel❑Other......._...... ....._....._..... _�..b..»..4...._.Z._ - i i - L- �1 t �-"±�-"f"-"y"•i ...-_ i � ... . Number of living units:..........Number of bedrooms_3...__. Sa.`.2�...1a�Q................ - 9 Garbage Grinder............Lot Size.... .. .-.. - — - -i-�•{ ' -}-. �_- "�b4-_,,_ AWafer Supply:Public System and name.............._.................... ......Private❑ � � `'»__�.,__! ._�.�a._-_ _,_„•„-,- Character of soil to a depth of 3 feet: Sand❑ Slit❑ Clay ❑ Peat❑ Sandy Loom❑ Clay Loam Er- Hardpan❑ Adobe❑ Fill Material ......If yes,type...._........_......._... i (Plot plan, showing size of lot, location of system in relation to wells,buildings, etc. must be placed on reverse side.) -}•-• -�•••--#• '�--11---�•-•1••-••--+•-•j-- --- NEW INSTALLATION: (No septic rank or seepage pit permitted if public sower is available within 200 feet,l "... _ .—€— .-L._.. At �t PACKAGE TREATMENT 11 SEPTIC TANK)) Size................................................ Liquid Depth Capacity....................Type...................Material...................-. No. Compartments ....._._... _...... Distance to nearest. Well ....................................Foundation......................Prop.Line............._...... LEACHING LINE-Cf f No. of Lines........................Length of each line .............. Total Length ...........___....._... - i I •• ! �••-•--• 'D' Box............Type Filter Material._...-_....._Depth Filter Material .......... N Distaste to naa � rosh Well_...._...._._______Foundation ....__..._..„__....... Pro Line ........................ -' I -- _ DlomeNr Number............................ Rock Filled Yes❑ No Q i �I ..L_._1......_-�L-- L_ ._ _.T............ SEEPAGE PIT [( Depth .................... Water Table De -Rock Size..................._........... Distance to nearests Well....................._........._....Foundation-............._... Prop.Line.__...._._.._..__ _ �. - �_ _�_ �-��.� _�-�_ {_....�... I I _��_�-.L-• _{__.L_.__. .�'.... REPAIR/ADDITION(Prev.Sanitation Permit#.................._.................Dote_......_.... SepticTank(Specify Requirements)................ ........................../..........................-........._............-............._...._........_ Disposal Field (Specify Requirements) »...lG..i#>•:! .X/..... frt. wy° t •^ - I............:............_........................................................._ -....-............................................_............... -- -- .........................................................................................................._........................_..........------------......_...._............_............. —}-- ---r— —{ -�—+--�--�— -- +—•—y- I—�j— -- —;--- —r - -- (brow existing and required addition on reverse side) ._j._..�. _-}'- �-•• i i.� 1 __ ... __ 1 hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County Ordinances,Slate Lows,and Rules and Regulations of the San Joaquin Local Health District.Home owner or(icer► • —� - --j-•----�—�- i ••-F--- �_..}_.___...:__ _._k__......_ sed agents signature certifies the following: - �� - �•—I•-�'-_ "I certify that In the performance of the work for which this permit Is Issued,1 shall not employ any person 1n such manner - Ll...• - _ ! as to become wbjea to W",Co.mpensallon laws of Caltfomla.”Signed _ OwnerBy...__. .. : 4. _......_._.........-........7BIe .c...... ' - '-'�-• ---�-•"�'-- ....._ I � 1 III other than ownerl _ FOR DEPARTMft USE ONLY ! !-�"-�} I'--T--t"'1. .•}•-..__..�..._..-r.._.. .. APPLICATION ACCEPTED BY_..................................... ... ..... . ....;_....DATE...�s.-..r�.F�'.73......---.. -� i_�- BUILDING PERMIT ISSUED..............___..__........_.... ......_ •.•-------. .. . ..... .. ........_.._._._DATE..._......-.._...-.•.-•`__..._. "-I'-'-1• -- •- -j- _.«........ ADDITIONALCOMMENTS.................._......._........._.... ..._.»..._....._._-.........._._.__.........._....»._.......__.-.......__...-......._.......... �� j - - [ - ............................................._...__._.-...-....__._....__............-_................_.......-....-........._-....-...._..........__...._...»...............__._ ._._.}.-. ij •�{ F- .. ..........................................._._.......____....-:...._..__._..._..._...__...__..-.._...---•-•--.....-----..__..........__......._..._.._....._-•--_._... ...•.....f.�- - - i--'- --'Y"-j-- _ _ _ _ — _ _ . a�► Rnal Inspecflon b t---i•- ._J.._._i........... . SAN JOAQUIN LOC41. HEA H TRICT -) -- '•"! . E.H.13 241-'68 Rev,5M 7/723 M