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�`•'✓r' ,� `�' APPLICATION FOR SANITATION PERMe. ���'* Permit No. 4
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<br /> (Comp" In Duplioate) oR Date Issued 9rl-q#-
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<br /> Ap Icetion is hereby made to the Sen Joaquin Local Health District for a permit to con►truot end in itch the work herein dMcribad.
<br /> This application is made, in compliance with County Ordinance No. 544.
<br /> JOB ADDRESS AND LOCATION.. 2243 So$ !lM'..Street
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<br /> Owners trams.,........».» Chris .Nialer.».,�Y.��.f?.Y...................._................
<br /> Address---.—.— S we ............... ... . ..... .._..,.. ...................»......,..... ,.. ......�.�..g��"."".......» .
<br /> Controctor s Name......,.... .... Da A�PARRISH & SONS
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<br /> hweflaiten wM serves Residence ij Apartment House❑ Commercial ❑ Trailer Court ❑ Motel (a Other.❑`
<br /> Number of Irving units: Number of bedrooms A... Number of baths A_. Lot she IRAAM.
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<br /> Water SupFha Public system :'Community system E3Private❑ Depth to Water Table��..ft. ;
<br /> Ciareafer of ail toe,depth of 3 foots Send❑ Gravel❑ Sandy Loam❑ Clay Loam❑ Clay❑ Adobe IN Ha+dpan❑
<br /> Prwkw Applioation Made: Yes❑ No EX New Construction: Yes Ig No❑
<br /> TYPE OF INSTALLATION AND SPECIRCATIONS:
<br /> (No sept%tank or oesspool pormiffed K pubko sewer is avallabie within 200 feet) F
<br /> Sop Tank: Di><tence from nearest well 1.....Dista afro dation. 1... �. `C
<br /> 1iM� No. of compartments»,.. ,Size' pp+_s!...Uquid depth .»...............Cepecily w.
<br /> Disposal Field: Distance from nearest weA....60......Distance from {wndefigo,19 a ...Distenon to nearat 1)� 1`
<br /> Number of lines.._ h _......., ..,Length of each line-2Y...... .. Wk fk of..ranch,....,,,.:.;ice....' ¢3
<br /> Type of filter materiel.„. ...._Depth of filter,materiel..............._...,Tout lengths N
<br /> See Pit: Distance to nearest well.. 100 a ,Distant f,< fou dation..l t to nearest b! t #r
<br /> �' �•'�er,,�f pih.:aa..._...»...Lining meterielC�SY`lOhe: Diameter., _Depth_.......
<br /> Cesspool: from nearest well..............Distance from foundation.............—.Uning materiel.........
<br /> ❑ Wor._..._.............................Depth............................................... .Uquid Capacity...»»._...».....,._gals. (A t`
<br /> Privy: from nearest well....:..................... .............._.._Distance from'neerest building—..._
<br /> ❑ .rams to nearest lot line...................................... ._............
<br /> .. ..,.........» ..»..»...:...
<br /> Remodeling and/or repairing (describe):....»..... .......:......
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<br /> I hereby corFify that I haw Prepared this appliaetion and that the work wIN be done In aoaordance with San Joaquin County
<br /> ardissances, State laws, and rules end mulet{ons of the San Joaquin local Health District..
<br /> ISi9ned)—.D.e. :a*PARRH,,, SOI!Sn .IRe.t.asss�.:rrr... .:��t�
<br /> •. ..:••t!M t ttft:fe..(Owner and/or Conkeetor)
<br /> _ _ �»Estimator
<br /> (Piet plass,showing stu of lot,k>catbon of system in relation to wels, buildings,etc., can be placed en revshse side)., »
<br /> FGA SIPARTMBW V1111 ONLY
<br /> APPLICATION ACCEPTED BY... ....... .............._............................»
<br /> REVIEWED BY......................
<br /> ....... .......:........ ...............
<br /> I BUILDING PERMIT ISSUED. ....... ......_. ..».............. ............................ ..... .............. DATE.».. ,.,..,.. ..»»_........_.,.............__..
<br /> Alterations and/or recomirlendatioms................................... M...•.._......» .._.
<br /> ........... ......................................................................................................................................................».........................._..,........,.. .._
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<br /> .._................................................................................ ..............................................................._............... ............ .» _.....
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<br /> FINAL INSPECTION BY:..................4�,;i. Date........ :. 1 r✓. 7...`.7...V/....»............
<br /> SAN JOAQUIN LOCAL HEALTH DISTRICT
<br /> IRO SeWh Amerkan Sim*# 300 Wed Oak street Ili Syeamere Sfeeet 814 N""C'Street
<br /> 31101110", CalHomia Leal. Calitemis Manhea,C11410mu Tracy, CalNomia
<br /> Es-9-2m 8•61 Revised W2100
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