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f a APPLICATION FOR SANITATION PERMIT Permit No. --1.------- - - {Complete in Duplicate} tf_ � f! 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 e in tom liance.with County Ordinance No. 549. /tF3 3oO—lZ application is mad { J06 ADDRESS AND LOCATION.___.North_Cardnal Ave. near R.R. Tracks (Steel Fence Around) Owner's Name-------•--�ti' & W- .Fine Foods,-- �no_*-------------------------------- --------------------- -------------------. 'Phone------------------------------------ ---------------------------- Stockton, cal. - ' ----------------------_---------`--` y .�.._ # ±_ . �,-... .� .. .�... Phone__.. _._ . Cont actors Name__PTx'.1=S:ha_ _ YiC-' - ---------------------------- -- ---- -- 1 Installation will serve: Residence F1 Apartment House E] Commercial ] Trailer Court ❑ Motel El Other ❑ �. 2 acres Number of living units: -------- Number of bedrooms -------- Number of baths .------- Lot size ------------------------------------------- ----- ----------- t Water Supply- Public system E Community system ❑ P'rivate ❑ Depth to Water Table 5ft. qu Charticter of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ AdobeDa Hardpan ❑ Previous Application Made: Yes ❑ No.;�] New Construction: Yes N No ❑ I ' TYPEOF INSTALLATION AND SPECIFICATIONS: I I {No septic tank or cesspool permitted if public sewer is available within 200 feet.} None 8' Concrete I I $Qpfi Tank: Distance from nearest well----__._.._____Distant fro foundation__________ -_..____.M; i�rial_.______________________________ _____________ L'I 5 ^3� l•D• ------------------------ Ac f--04 Ga } No. of compartments------tWO-----------Size---------------------------- Liquid depth - Capacity - Disposal Field: Distance from nearest well. -_none Distance from foundation__-5�_�.______.Distance to nearest lo2t4i Me----- T Number of lines-------- 021 ii_.__rOCLength of each line_---b------81 ----------.Width oftrench6O Y-------------------------- I l I Type of filter material----- i--------------4epth of filter material-----------------------Total length--------------------------------------'-- Seepage Pit: Distance to nearest well----------------------Distance from foundation--------------------Distance to nearest lot line----------------- Number of pits----------------------Lining material-----------------------Size: Diameter --------Depth----------------- } i1 t Cesspool: Distance from nearest well-----------------Distance from foundation___._.._____-_____..L'sning materia_.._______.________.____.____--_-___. 0 Size: Diamete`r-------------------------- ----Depth_------------------••------------------------- Liquid Capacity-_--- Distance gals. ` Privy Distance rror�i nearest well------------------------------------------------_Distance from nearesT building-----.----------------------------=------ ❑ +: Distance to nearest lot line - ------------------------------- s Remodeling and/or repairing (descrbe)_________________-------5Y__stem---to___sErve-___s__ 11.--seas-oral-_office-•Bldg-� \.l 4 -------------------------------------------------- --------- ----------------•-- --------------- M --------- ---------------------------------------------- t ----------*--------- ----------------------------------------------------- ---- -------•------------------------•------------------ = `� �'---------------------- - 4.` I hereby certify tharl 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. t. I .g } Parrish lnc� 91 ---- --- --- - --------- ----------------- ------Owner and/or Contractor) I S' ned ----------------------------M------•--------- -� -------- r �T ._...- ' � � �� ` .--President Miles A, Parrish - - - -------- -- -- ----- --- -- --- ---(Title)-- ----------------------- -------------- - ---- - fl (Plot plan, showing size of lot, location of syste ' relation to wells,"buil i s, etc., can be placed on reverse side]. F = I FOR DEPARTMENT USE ONLY t : N -------------- APPLICATION ACCEPTED BY-------------- a----------------------------- 1---- ---- -------- - DATE : `� _ I ,-� GbATE �� REVIEWEDBY------------------------------------ --------�• ---1--�-�-- - - - L I r. DATE ---------------------------- -- PERMIT ISSUED -- - IAlterations and/or recommendations: I ---------------•_------------------------------- --------------------------------------- ---------------------------------------- ------- -------------------- -- ------------- II ---.-_-------------------------------------------------------------------------------------...--------------------- - } _. - ------------------------------------- ----•----•- ---------------------------- -----------------------•------------------------------------------------------------------ ------- _-} l --------• -----------------------------------------------------------------•----------------------------- ---------- ------------- 9 + ------------------------------------------ --------- ------•-- 1 ........ .. � - -- - -�- -°Date ` �INSPECTIOiV-�BY:�-=- ,:=--=--------------------- --=--�-.b.-�- ------- ---"'�.'""--`�"-`------------------------- FINAL SAN`JOAQUIN LOCA HEALTH DISTRICT' .Le .130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-4-21VI 10-52 Revised W-2100