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APPLICATION FOR SANITATION PERMIT Permit No. -- ----------- (Complete in Duplicate) �4 fes' 3 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. JOB-ADDRESS AND,LOCATION-----------1901 Cherokee Lane. .. , Stockton Emil J, Seliner 6--6131 Owner's Name--------------------------------------------- - --------•--------------•----------------------- --------------------------------------------- Phone------------------------------- 1901 Cherokee Lane Address--------------------------------------------------------- . - ----------------------------------------------------------------------:-------------------------- ------------------------------- -- --- P {RTSH INC *: 9-9607 Contractor's Name----------------------- - R Phone----------------------------------- _Ilk ... - --- .lk Installation will serve: ResidenceNN Apartment House ❑ Commercials❑ Trailer Court, E] Motel E] Other E]Number of living units: -1---- Number of bedrooms .3aths_-_= Numl'er of b `'..l Lot§s ze�.-12Q_t.__X---15 f................ Water Supply: Public system K Community system-❑:?rivate ❑__Depth.to WaterToble:=.40-ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ElSandy Loam ElClay Loam E] [je,Clay AdobHardpan ❑ Previous Application Made: Yes ❑ No [X New Construction: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS.1Iepraement, (Nb septic tank or-cesspool permitted if public sewer is available within 200 feet. None 1 15 @@ Brick p -----Distae from-foundation---- -------.Material------------------ ------------------------------ Ax• ' Septic Tank: Distance from nearesr well_..........: E�jj p s rt n ., r No. of com artments.............. Size Liquid depth -52..:..- iCapacitY �dO_ ------------ 3 dibNonei Distance from fouendatio n2 .!......__ Distance to nearest IJ Ene-.... Disposal Field: Distance from nearest we,l.-- 51 1 2F �' x 1 ® Number of lines.............::.. xH } Length of eaci line.l" z _aae..'Width of trench-...-.--l _-_____-___ -*-- _ ' p -------- Type of filter material..... ....R -Depth of filter, materiaZZ s-_-1.8n__dotal length-_r..g'...0--0-�C- -----------------I - 7 l � p NOI1e Distahce'fr - foundation�0....:.........Distance to nearest lot line-----1�_....._ Seepage Pit: Distance to nearest well Number of its----1...............Lining materi}l-_-407 1� �'_1Cke: Diameter--------- Depth-.:.._2 f s Cesspool: Distance from nearest well........... .....Distance from•foundation..---..-_.-.-...Lining material-----------_m_-._---.----------------❑ Size: Diameter-------------------------------�----.Depth---------------------------------------y�-- .Liquid Capaci'y----------------------------gals Privy: Distance from nearest well___________ ------------------------------------Distance from nearest building ----..._..-_- ❑ Distance to nearest lot line........................ ------------------------ ---------- - Remodeling and/or repairing (describe):-----------------------`----------------------------------------------------------- ------ 'r ---------- 1t W% ----------------------------------------------------------------- - ------------------ -----••--- --------------------------------------------------------•------------------- -------------------•----------•--------------------------------------:------------------------------------- I hereby certify that I have prepared this application and that"fhe work ' ill be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations o San Joaquin L cal e1alth'District. PARRISH IN {Signed} ------------------ ----- -- (SRM Contractor) By--------------- --- --- - - - ----- -(Title}- Estimator �,c_ ----- (Plot plan, showing size of lot, location f Sys elation to wells, build' s, etc., can be placed on reverse side}. FOR DEPARTMENT USE ONLY - APPLICATION ACCEPTED BY ----------- - --- -- ---- --- -- •-- - DATE--- REVIEWED BY--------•--------------------------- ° DATE --- -2--- ---�- / ---------------- BUILDINGPERMIT ISSUED---------------------------------------------------------------------------------------------------- DATE---------------------------------------------- -- ..AltAlterations erations and/or recommendations:-------------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------- --------In-------------- -----------------------------------------------------------------------------I•------•----------------------------------- - ---------• --------- ------------------------------------------------------------------------------------------------------•----------------------------------- ------------------------------ --------------------------------------- ----------------------------------- ------------------------------------------------------------------------------ ------------------------------- FINAL INSPECTION BY---------------- �' lt ------------------ Date_.... ------------ b j-- - ------------- --------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Sfockton, California Lodi, California Manteca, California Tracy, California ES-9-2M 10-52 Revised W-2100