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FOR OFFICE USEt / 1 . . APPLICATION FOR SANITATION PERMIT ,.. .... ..., r/�• � Fermin No.�.�.-..�.✓... ''}} (Complete In Tripticatel ............:............n �... ............... This Permit Expires I Year From Ogle Issued Date Issued 6.=X-: Application is hereby made to the San.Joaquin Local Health District for a permit to constrict and install the work heroin described. This application Is made M compliance with County Ordinance No. 544 and existing Rules and Regulotionst JOB ADDRESS/LOCATION .........9211 Alhambra (treat side of Tracks) .....CENSUS TRACT .......................... Owner's Name ............. Don 8...Zawley............ .... ....... ..................Phone .................................... Address ..................:...................9211 Alhambra,..---.........................City ...Sto_ckton........................... ........... Contractor's Name .& Sorin- Inc...........................License# 100511....... mum 4669607......... Installation will serves. Rosidencaft Apartment House fl Commercial QTrailer Court Motel❑Other............................................ Number of living units:-.(3.)... Number of bedrooms .....'3....Garbage Grinder ....Y919 trot$ize ..Q4f..Aq?:A..................... Water Supply: Public System and name ........................................................_..»..............................................Private WE Character of soil to a depth of 3 feet: Sand❑ Slit❑ Clay MC Peat❑ Sandy Loam❑ day Loam❑ Hardpan❑ Adobel Fill Mohrlal............If yes,typo............... ............ (Plot pian, showing size of lot, location of system In relation to wells, buildings, etc. must be placed on reverse skis.} NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 fe03 PACKAGE TREATMENT I I SEPTIC TANK( I Size................................................ Liquid Depth .......................... Capacity Typo Material...................... No. Compartments ...............»..». Distance to nearest: Well Foundation Prop. Una LEACHING LINE [ j No. of Lines ........................ Length of each line............................ Total Length .........................» 'D' Box ............ Type Filter Material ....................Depth Filter Material ............................................ • , Distance to nearesh Well.. ...................... Foundation ............... Property Line ................ ..... SEEPAGE PIT ( j Depth .................... Diameter ................ Number ............................ Rock Filled Yes ❑ Net Q Water Table Depth :..... ............................Rock Size ................................ Distance to nearostt Well ..........................»............Foundation .................... Prop. Fins ..................» REPAIR/ADDITION JPrev. Sanitation Permit#11.......................................... Date ................................� SepticTank (Specify Requirements) .......................................... ..................»....»....»......»....................»............................... Disposal Field (Specify Requirement4/........Uldili.01MI...7.5-..1t*r ...,B41,G1I-..cIrai A..AAd..3 ...4 di-46—Pit........ ...--•............................................................................................................._...................................................................................... ..........................................................................................•................._............................................................................................ (Draw existing and required addition on reverse sidel I hereby certify that I have prepared this application and that the work will be done In accordance with Sas Joaquin County Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local No" District.Neale owner or lke* sed agents signature certifies the following: "I certify that in the performance of the work for which this permit is Issued, 1 shall not employ any person M such Mame► as to become subject to Workman's Compensation laws of California." Signed ....D.A...Parrish & Sons, Inc. .... Owner V By ........Miles A. Parrish .t . Jitte ...Contr....................................................... (If other than owneri FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY ... ...................................... DATE BUILDING PERMIT ISSUED ......................................... ..............................................................DATE ........................................... ADDITIONAL COMMENTS ............. ...I.........................-• ...........................................................................................................----.................................. .............................-••........................ .... ... ..... .. . . . ......... .. . :no inspection by. Date . .. 7 EH 13 211 1-68 Rov. 5H SAN JOAQUIN L L HEA DISTRICT $f 7�t �3-M