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APPLICATION 'FOR SANITATION PERMIT `!r" (Complete in Duplicate) Application is herebymadeto 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. DMZ f ^ 200 r.3 ADDRESSJOB AND LOCATION___-_L: n en__-UeMentar__--S-� RQl- -- ii��e1l Qa�1_. __Linden---WAP-e ' Owner's Name---------------Linden--School, D str-i�ct ----%--_Q.___-w Moznet_ .......Cl-erk. Phone------------------------- Address----------------------------ZZXXYx -Pa--0,--a0x-- leo,. ---Lix Linden--------------------------------------- Contractor's Name------------DA---AA---PARRISH---&__,50U_j----INC---------------------------------------- ------=------ Phone--9-9607.------------- / Installation will serve: Residence ❑ Apartment.House ❑ Commercial [❑ Trailer Court ❑ Motel ❑ Other X Sc11oo 'Number of living units: 'E?� Number of bedrooms n Number of baths f] Lot size----.---Ac-res-.--„--.----------------------------- Water-Supply: Public system L] Community system El Private EX L Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe EX Hardpan TYPE OF INSTALLATION AND SPECIFICATIONS: '► s (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well----2_QQt__Distance' from foun,dation_____12_........Material------C E No. of compartments----------3------•------capacity----150- 5alze___5P—FX---6Q...tt----Liquid _�depth '-_]__.4C�$--_____-_-_-_-_-_-_-_-_- Cesspool: _ Distance from nearest well_________________Distance from foundation____--____________.Lining material-____--_______________-_____________- ❑ Size: Diameter Depth ----- ` M: __ _ _______________________ 1 -Privy: Distance from nearest well______-"----------------------------------------Distance from nearest building______-.------______________------_-___- ❑ Distance to nearest lot line------------------------------------------------ See a e' Pit: Distance to nearest well_______ QQ _____Distance from foundation_ P 9 �- I_QQ__-------Distance to nearest lot line------1Q__Z Number of pits---------I-----------Lining material-----C--- Diameter----------5W -----.Depth-------2-01------------------ i Disposal Fielcl Distance from nearest weir- a=_.Distancehorn foundation .Q ______�_Distance;to neares}-lot;fr Number of lines----------Z.----------------------Length of each line------ ---------Width of french---RW!----------------------- Type __________________ __Type of filter material------L1...... I-C_Depth of filter material-------- $i,------- Remodeling and/or repairing (describe: -*# -- ---0--_-- 5-Rd__Sa�,-__5y$ 1T1_- lr'ec C� --_ 1__1,� ___ ----------- ------- ____.___- -------L-Lnae-ri_-Els meatarY----S Cho 03-__a ddit ion:---This---ad_d i ti an__has----5--toile_t-s----and---1---------------- Ura-.nal .ani.---c1a-s_sra-an--s-i�-d------Exis- J-ng__t --sS---3Q1---1-ong-r--- t----gide---&--7t....de,. p.r a.r�d.__with---X00--fin-_f t.----i e ching---drain_-and__wIll---remaa.n--ixL__use.-•-. I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, S to laws, and rules and regulations of the San Joaquin Local'Health District. (Signed) A P V -----------------�----------------_---------------- ----------- Contractor) By:.-. ---- ---- ----- ---------------------------------(Title)------ S_t_:LW t D -------------------------------- (Plot plans, Ilk wing size of lot, location of em in relation to wells, buildings, etc., must be filed with this application). FOR DEPARTMENT USE ONLY C� APPLICATION ACCEPTED 13Y _ ---- V-- ------------------------------------------------ DATE---- --------------- REVIEWED BY - -------------------------------------------------------- ------ DATE-- - BUILDING PERMIT ISSUED------ DATE Alterations and/or recommendations: --- Q- -t�_,----_Q-' _ -S. - _- -th -- s - ' L--- A_o_e---- C __ bZt._.�JIT_dls?-UAZ,--f--- cyj Al A4 hi-t-4 PERMIT No-77-1----- ISSUED--!-------------------/----------------- FINAL INSPECTION BY..... ��s--- Date------------------------------- --------- ------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 136 South American Street `y Stockton, California ES---9---2M 9-50 W-1639