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APPLICATION FOR SANITATION PERMIT Permit No. (Complete in Duplicate) o i` ' I�` fTi ,✓ 1 Date Issued ---f.-_/_--/-5---/ {Y" u Application is hereby made to 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. JOB ADDRESS AND LOCATION-----------------3937 Alvarado Street Owner's Name----- --------- Barr Barba elat& Phone- - -------- - - Address--- Sane as above - -------------------------- -------------------------------------------•--------------------------I------------------------------------------- Contractor's r„ame------------------------ Parrish Inc. Phone H°-6--�9--��- 07 Installation will serve: Residence ® Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: Number of bedrooms -..2.. Number of baths --- Lot sizes0-_________-__________._.--.._ Water Supply: Public system ❑ Community system ❑ Private ® Depth to Water Table 401 ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe [3 Hardpan ❑ Previous Application Made: Yes ❑ No E3 New Construction. Yes ❑ No 29 FHA/VA; Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest veli_ _.___._.____Distance from foundation-------------------Material............................. Ex"ting No. of compartments-- - - -- - - -- -.--Size-------------------- - - ----Liquid Jepth--•........ - - ----- - Ca pacify---------- --- --- --- Disposal Field: Distance from nearest weli_ 50--------Distance from foundation_ __1-Q........Distance to nearest t line__5___--- ® Number of lines---.-.1.__._._._..__. --Length of each line____ 3.1 _____________Width of trench... ___--_... Type of filter material-----8__.rock Depth of filter material..._' .... ......Total length.....____C---..---.____ ------------ ----------- --_--._. r Seepage Pit: Distance to nearest wel€_. "_ .__--------Distance from foundation-------------------- ce to nearest lot ljr�..5_____-____- Pq Number of pits------.3-. Lining material__-_ rock size: Diameter----.---_-- .---.----Depth--. -- ---------------- Cesspool: Distance from nearest well.......... ...._Distance from foundation--------------------Lining material----------------- ----- ❑ Size: Diameter- - -- --------------- Depth-------------- -- ---------- -- - ---------------Liquid Capacity----------------------------gals. Privy: Disfance from nearest well -------------- ------------------------------Distance from nearest building-------------------------------- -. -.... ❑ Distance to nearest lot line-- --------------------- --------------------------------------- -- Remodeling and/or repairing (describe):---------------------- ----------- --------------------------------------------------------------- ------------------- -----------------------------------------------------------------------------------.-- ---------------------------------------------------------- ------------- -------------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. (Si(Signed) Parrish nC 9 .(Owner and/or Contractor) By:-----------------------------------------3-1-1-1-- Wright----- --- -------------------------- ------ --------------- � (Title)-- E --------------------------------------- (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED $Y------�4k-0.'- - -- - --- ----- - ---------------------------- ------------------ DATE---- -16--- REVIEWEDBY----------------------------- ---- - ----------------- - - ---------------------------- - ------------ - .- DATE------ ------------------------ --- - - ------------•--------- BUILDING PERMIT ISSUED-------------------------------- ------------- -•-------------------------------------- DATE-- --------------------------------... Alterations and/or recommendations:------------_-----------. __-__.___..---- . - -- --------- - -------- ----- f=T----- 'T _ .-- -r_.. /_ ' � � - 3 ._ ---------------- ----- ------------------ FINAL fNSPECTION BY:- ---/,". cr'= rte ` - -- D .' ate r .... SAN JOAQUIN LOCAL HEALTH DISTRICT 00 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2M . Rovi5oa 1-57 F.PCO.