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APPLICATION FOR SANITATION PERMIT Permit No. .- -_3_g....._ (Complete in Duplicate) f sem' Date Issued _----.7---•---_----- Applica-lion is hereby made to the San Joaquin Local Health District for a permit to construct and install the worVherein described. This application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION-----BROADWAY__HATCHERY --t-,---��.-E-�r---Fremon�__5tr��-�___S�ockt.on_._ Owner's Name-----------------------------------•-« a .AR 4-------•----------------------- ------------------ ------------------------ Phone---HO---1+090!]----- Address--------------------------------------------- S&=Q--------------------------------------------------•-- ----------------------------------•-------••--------•-------------------------------- Contractor's Name-----------------------------PI RI SH-- c--SO T'S' ----INCA------------------------------------------------------- Phone---Ho ---696.07-------- Installation will serve: Residence [-] Apartment House ❑ Commercial ❑ Trailer Court [❑ Motel ❑ Other KI Hatchery Number of living units: -------- Number of bedrooms .------- Number of baths ----1 Lot size 1001---x1-501----Sal-GS__--_- Water Supply: Public system ❑ Community system ❑ Private ZX Depth to Water Table 50.- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe=Hardpan ❑ Previous Application Made: Yes ❑ No [X New.Consfruction: Yes ❑. No ❑ Supplementary Drainage 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-----------..--.--.---.-__---.----.--.-----.--. ERLSting No. of compartments----------- -------- -----Size--------------------------------Liquid depth----------- ---------Capacity------- -------------- Disposal Field: Distance from nearest well---------------_Distance from foundation--------------------Distance to nearest lot line..----------.---- k ❑ Number of lines-----------------------------------Length of each line---------------------- ----_Width of trench----------------------------------- Type of filter material----------------------_-Depth of filter material--------`---------.--.Total length------------------------------------------ Seepage Pit: Distance to nearest well-.-----100.1----Distance from foundationlQ- Distance to nearest lot line--.--.-- Esp ----------------- 171 ting & Number of pits. _ .__-.---..-.___Lining material--- r -.-. Size: Diamete>3_t�--- Depth------ 51 _---_---_ Cesspool: Distance from nearest well-----------------Distance from foundation__.------.'---..--.Lining material----------.._- --------- .-_,Y----. ❑ Size: Diameter-.;.-------------------------- ---------Depth------------------------------------------------- --Liquid Capacity----------------------------gals. Privy: Distance from nearest well-------------------------------------------------Distance from nearer building----------------------------_------------- ❑ Distance to nearest lot line-- ------------•------ -----------------•----------------- ----------------------------••---------------------------------------. �Ul lRemodeling and/or repairing (describe)-------------------------- ---------------------------------------------------------------- ------------------------------------------------------------ ---•-•----------•-•----•--------------------------•---------------------------•------------------------------------------------•---------------------•-------- ------------------------------------------------------------- ------------------------------------ - --------------------------------------------------------------------------------------------------------------------- -------------------•---...._....------------------------•------- r ------------------ ----------------I--------------------------------------------------•--------------------------•------.-. --•-------------•-I----------------------------------------------------------- I hereby certify that I have prepared this application-rrd that the work will be done,in accordance with San Joaquin County 'ordinances, State laws, and rules and regulations of t�_TNC San Jo quin Local Hca `Uist�ict. (Signed)-------------------D•----A....POSH---&---SONS7 . - - ---------- ---- ---------------------------------------(0)GO[URM Contractor) By:---------- ----------------------------------------------- ------------ ---- - --- --- ----------- ---- . -----(Title)----EStimat-iar--------- ---------------- (Plot plan, showing size of lot, location system in relation owe s, 'ngs, F, an be placed on reverse side). FOR�DEPA MENT USE ONLY APPLICATIONACCEPTED BY. - ------------------- - - ------------- •-------------------- DATE -------------------- ----------------------------- REVIEWEDBY--------------------------------- ------------------------- ----------------------------------------•------- BATE BUILDINGPERMIT ISSUED-------------- --------------------------------------------- DATECA ------------- -----------------------•- Alterationsand/or recommendations:------------------------------------- -- --------------------• -------------------•-••--•--------- -----•-----------•------------------•--- -------•----------••----------------------- ---------------------------------- ------------------------- --- -----------------------------------------------------------------------•--------...._..-------------------------- ---------------- ----------- ......I------ --------- ..........-•••-------------------------------------------------------------------------------------------------------..-..-------------------- ---------------------------------- ---- ------------------ --------- ---------- --- ------------------------=-------------•--------------••---- •-----------------------------••--------- ---------------------------- - ------------------------------------- ---------------------------------- ---------------- •--------- ------------ ----------------•--•---------------- -------------------------..-.......I------ FINAL INSPECTION --------- ------------ Date---- ` � � ---------------------------- SAN ...-. JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 Wast Oak Streat 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California r' E5-9-2M 145446 ATWOOD 12-54