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APPLICATION FOR SANITATION PERMIT (Complete in Duplicate) Application is hereby made to the San Joaquin Lccaf 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-------------3-9--West---8the--- ----------------------------------------------------------------- Owner's Name------------------------------------------------P_PAS-c-aul-lbarr-a------------------ - ----------------------------------------- Phone----1#'_-a.8f21------------- Address-----------------------------------------------------------3-9-West--- th------Street:----Stoekton----------------------------------------------------------------- Contractor's Name------------------------------ D. A. P.ARRISH & SONS INC•- Phone 79607 Installation will serve: Residence X]. Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: [31 Number of bedrooms [a Number of baths Ex Lot size--__40.1_x75!____________________________________ Water Supply: Public system [X Community system ❑ Private ❑ Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay E❑ Adobe Z Hardpan ❑ 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----------------------------------------------- ElNo. of compartments----------- _--------Capacity-----------------------Size-------------------------_-----Liquid depth- --- Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material_____-_-----_______________________._. ❑ Size: Diameter--------------------------------------Depth------ --------------------------------------------- Privy: Distance from nearest well------_-----------------------------------------Distance from nearest building------------------------------------------ El _.-_-_-_ __-_-_-__-________-___.__.❑ Distance to nearest lot line------------------------------------------------ �r Seepage Pit: Distance to nearest well----NOUe------Distance from foundation-----Ss---------Distance to nearest lot line-__51-------- KI Number of pits------I------------Lining material--CDn__ar---Size: Diameter------- Depth _Disposal Field: Distance from nearest well__NQnB---.Distance from foundation_'___Z+_...........Distance to nearest lot line----L•1-____-_-_ EX . Number of lines----------------- _______________Length of each lin e----------6-0............... of trench----------24".----__------_-- Type of filter material-_._1*11--.Rk_-_Depth of filter material-_-- -,8"---__- 'Remodeling and/or repairing (describe)------------------Dral';age---4ff.._exist.ng--- Bs4k---Y$-rl----- --------------is---- ompIRte-ly__eaturated---hence----this-_route------------------------------------------------------------------------------------------ -------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------- - -- -- - ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ --------- i hereby certify tha+ t have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, laws, and rules:andregulations of t e San Joaquin Local Health District. (Signed)---------- -.- A-*----PA=R--- --- -- ----SONS ---------Cr'---- *---------' -' -------+--------'-------A--------- --------- (� r Contractor) By---------- --- , a------- ------------------------=----------'-----------------(Title)-_-E S t ip. 1-t or (Plot pla s, sh ing size of lot, location of system in r ti to wells, buildings, etc., must be filed with this application). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY----------------- - DATE--------------- --- r - --- ------------------------- REVIEWEDBY------------------------------------------------------------------------------------ - -------- - ------ ----------------- DATE-------- - - -----4 BUILDING PERMIT ISSUED--------------------------------=--------------------------------------------------------------------- DATE---------------- --------------------------------- Alterations and/or recommendations:------------------------------------------------------------------------------------------------------.--------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ ---------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------- ----- - ------------------------------------------------------------------------------------------------------------------------------------------------------ ------------------- ------------------------------------------------------ oe PERMIT No.63713---_-- --_ ISSUED----- FINAL INSPECTION BY:------ ---._L( +_._ ---- ---------------------- Date---------------------- ------ -----------_-------__Date--------------------- -----. -------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California ES-9-2 M 9-50 W--i639