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APPLICATION FOR SANITATION PERMIT Permit No. .�0 to in Duplicate) 3 (Complete p � Date Issued Joaquin Local Health District for e permit to construct and install the work herein described. Application is hereby made to the San This application is made in compliance'with County Ordinance No. 549. . t i `2122 East Eighth Street _ . JOB ADDRESS AND LOCATION_____ -.-- --- J C Reynolds - - --------------------. . ;------------ ------ -------_u '" a "_ ." Phone_ OwnersName-------=---•--�•---�------- ---------------•----------------------•--- -.-.,.::r.-:�:-:r-......,_,.-. Sameas. above ... ------------- --`----------------- ------------------------------------------- Address-------------------------••----------••-----------•-------------- I , ' = ------- --------- Contractor's P Trish---&--ions---Inc-,---- ----------------�h H06-9607, .,Phone----------------------- - r Contractors Name------ ..----_.___ _�--- Installation will serve- Commercial Residence�] Apartment House Commercial El Trailer Court ❑ Motel s❑ Other E] 1 Number of living units: : "-"_ Number of bedrooms *-�" Numbe�-af baths _3 __ Lot size-,;----------------------- m's " 1 i 1 Water Supply:—Public system X Community-system ❑ ; Private ❑" Depth to Water Table _45_ ft. Character of soil to a depth of 3 feet.' Sand E] Gravel f-.1Sandy Loam"❑ Clay Loam ❑ Clay ❑ Adobe® Hardpan ❑ Previous Application Made: Yes E] No Pq New Construction^ Yes ❑ No [ FHA/VA: Yes ❑ .w No El F I TYPE'OF INSTALLATION AND SPEC'IFICATIONS: " ° 1 (No septic tank or cesspool permitted if public sewer is available within 200 feet.) w Septic Tank: Distance f}om�neares+'well_______________"_DistanI from foundation__--____.______-.-_.Material Li uidFde th - - 1 Capacity Extirig No of compartments = Size :-__.. q P - S - - i Disposal Field: Distance frorn nearest well__.. Distance from'foundation__________ ________Distance to nearest lot line __-__-________.. :. Ext§ting " Number of.lines---•-- •------------------`Length of each line-------------------------------Width of trench -' Type of filter material--------- -Depth of filter material--------------- -----Total _length-.-•---- _------------ti---;5�---- N one_ ..: o` o, Seepage Pit: Distance to nearest well___"______"__.__"____Distance from foundation_3......:.. ......Distance to nearest lot li`e-"_.:_'.-__-_____ n _ N tuber of pits- .__ Lining material__�-RIDCk------Size: Diameter----33--- ---------Depth_ 2 -- Cesspool: [Ystance from nearest well ..............-.Distance from`foundation--_ - '_ 'Lining'materia------------------------ ---- __ _ + �De th ILiquid Capacity ----------------- ---------------------------------- 5als ❑ Size: Diameter-- ---_ --" -- p74, A T I Distance from nearest building Privy: Distance from nearest well --------------- --^' -------------- ❑ w � tom' r -.. -- " -"----- ------------------------------ + - , .. -- _ • � ° Distance to nearest lot~1me__-__ -------- - - - --- - ti ----------- - Remodeling and/or repaEr�ng [describe}:______________________________ ---– : - - . --- -------. ------- ------------------------------- S Stetlt + F t add o exist_ rig Y - ----------------------------------------------------'----------- = - -- ---------------------------------------- ------- ----- .. .� , I ..: . - - - ------------------------------------------------------------pa; --•--- I hereby certify that I have prepared this application and that the work will be done.inyaccordance with San-Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local'Health District.:,' T D A Parrish#r& Sons TnC. 4 __(Owner and/or Contractor) - ----- -- -- (Signed) = E - -- Bill Wright �By:._..---- ----------------------- ----------• --------•--=--------------------------------(Tit) -------- ----------------------...---------------------- By: - ----- --- -------- ---------------- (Plot plan, showing siz"of lot, location of system in.relation to wells, buildings, etc., can be placed on reverse side). #, I A , F FOR DEPARTMENT USE ONLY t APPLICATION ACCEPTED BY--------- ---- -- DATE t - 4 ,' - _-------------- DATE-----:-- _--•-------------- -------- BUILDING PERMIT ISSUED----------------------------------------- - ---------- -;--- DATE-^ - - ------------ Alterations -- REVIEWED BY `-----=-- - -- ----- ------- ----------- ------- i, t , t ---- - mmen ations:---------------_ ------------ - --------------------- 1 Cera ions an or Tec � .�.,. ------=-------------------------------- --.: 7 --- _______ _ __________________________-----------_'--'-_-_ ___-_- _____------.__.______--__' _ ---- - ' -_ 4 _-------------- ------------------------------- _____________ ------- -------- ------------------------ - - ---- ------•--- v ------ -- ---- f u,.�_{ . -. _ . ._h. Y Date ' =�=-�-- ------------ - FINAL INSPECTION BY:_�^-------------- --- . ----- -------- -1 SAN JOAQUIN LOCAL HEALTH DISTRICT 300 West Oak Street 132 sycamore Street 814 North "C" Street 130 South American Street Trac California Stockton, California Lodi, California Mantera, California y ES-9-2M Rev'ssea 1-57 F.P,CO.