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I APPLICATION FOR SANITATION PERMIT (Complefe'in Duplicate) 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 LOCA �4SN TION------------------------ --- ----- i7« Street, -------------- -------------------------------- Owner's Name-----------------------j-----------_John---Sb-rAgl.A---------------------------------------------%------------------- --------- Phone-------37n1009------------ Address = - II 112 Sycrnore Ave. Stockton ------------- ---------- -------------------------------------------------------------------------------------------- Contractor's Name---------------1i----_-- D.A. Parrish & Sons, Inc. 8597 ---------------------------------------------- -------------------------------------. Phone-- ---------------------------- Installation will serve: Residence JK] Apartment House ❑ Commercial ® Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ® -]Number�of bedrooms P Number of bathsLot size------------------------ -.112 i Water Supply: Public system M Community system ❑ Private ❑ Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ AdobeU, Hardpan ❑X IN TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance'�from nearest well-----------------Distance from foundation_--_____-_-_---_-_-.Material____-------_------ __----. ❑ No. of compartments--------------------------Capacity-----------------------Size--------- ----------...........Liquid depth------------------------- Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material------------------------------------ 1771 Size: Didmeter--------------------------------------Depth---------------------------------------------------- Privy: Distance from nearest well------------------------------------------------Distance from nearest building-_----_--------------------'_------__---. ` ❑ Distancerto nearest lot line----__ 1 1 Seepage Pit: D' to nearest well______ flQ-�__-__Distance from foundation---- -__------_Discl� to nearest lot I2 ---____. .t- ® Number;of pits---------Orae----Lining material__COn'_- BrSize: Diameter-----------------------Depth-----------2-9--f Field: Distancelfrom nearest well-30----_-_.Distance from foundation- 2-fl-f--_----_.Distance to nearest �J oe--------f_-_--_ Numberlof lines----------- Length of each line--------------- Width of trench----------------------.--_____---- Type of lVfer maferial �'-��---_ro-C---Depth of filter material-----_--I��-_-._-__ I� additional to existing drainage system Remodeling and/or repairing (describe)-- ---------------- - - - - - - - --- - ---- - - - - - - ----------------------------------------------------------------------- - ....- --------•-----------------------------------------•------------------------------------------------------------------------_-_---------- ----------------'----------------------------------------------------- ij --------------------------------------------------------------------------=----------------------------------------------------------------------------•----.---------------------------- --------- ....---_------------- - 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. Si ned D A- Parrish & Sons Inca f►'" . Owner and/or Contractor ( g i�. - - ---- -- - - - -------------- ( / ) Title President ------------------------------------- ------------------ (Plot plans, showing size of lot, location of system in re ation to wells, buildings, etc., must be .filed with this application). FOR DEPARTMENT USE ONLY . APPLICATION ACCEPTED�IBY------- � ------ DATE------- �f ------ ---=------------------- REVIEWED ------------------ RE IEED BY----------------------- I------------• - - - ---------------- ----- DATE BUILDING PERMIT ISSUED-I----------------------------------------------------------------------------------------------------- DATE----------------------------------------------------------- Alterations and/or recommendations---------------------------------------------------------------------------------------------------------- • II ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- - ------.;----------- -------•------------------------------------------------------------------------------------------•------------------------------------------------------ � ------------------------------------------------j--------------------------------------------------------------------------------------------------------------------------------------------------------------I------------ 1�; PERMIT No-------/Q(--------- (ISSUED-----ll---= -• �__U-------------(Date) FINAL INSPECTION BY:--------_"`