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FOR OFFICE USE: i .................. 9 3 d APPLICATION FOR SANITATION PERMIT ....•-----------------•- --• �S/ate v ..........I........ - ----------- Permit.No. ....-• lComptete in Triplicate) -.-.__..... ...... ............ Date Issued ......... ...... This Permit Expires 1 Year From Date Issued 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 and existing Rules and Regulations: JOB ADDRESS/LOCATION ----------2847..Soa.."!f----St+ R#r.....................................................CENSUS TRACT ......__....-------------- Owner's Name ........................$ui• ToMppe1 Phone 9li8. 7111 ................................................................................ .... ............ ......... ...... ... jaw_.......... ......................................City ..............Stockton..... ... Contractor's Name .--._I?._..A...-- arri�h-& ons h►e.---•---•...................License# ......-.-............... Phone .A� §!!�7...._. Installation will serve: ResidencelM Apartment House Commercial❑Trailer Court 0 Motel❑Other............................................ Number of living units:--1_------- Number of bedrooms ----3......Garbage Grinder ............ Lot Size ....4Acres ...................................... Water Supply: Public System and name .............................. ......Private Character of soil to a depth of 3 feet: Sand D Silt❑ Clay ❑ Peat❑ Sandy Loam D Clay Loam Iff Hardpan❑ Adobe 1; Fill Material ............ If yes,type (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side.) NEW INSTALLATION: (No septic tank or seepage pit permitted If public sewer is available within 200 feet,) PACKAGE TREATMENT [ ] SEPTIC TANK f ] Size--------------------------------6............... Liquid Depth .......................... Capacity .............. ..... Type ... ................ Material._...................... No. Compartments 00 Distance to nearest: Well ............ . Foundation ..._. ................ Prop. Line ....................... LEACHING LINE [ ] No. of Lines - ------------------ Length of each line............................ Total Length —I 'D' Box ............ Type Filter Material ....................Depth Filter Material ............. Distance to nearest: Well ........................ Foundation ........................ Property Line ........................ SEEPAGE PIT [ ) Depth -------------------- Diameter ................ Number -------------_-----_---- Rock Filled Yes ❑ No (:] Water Table Depth .............. --------------•--•-----•--•---....Rock Size .........................-...... Distance to nearest: Well ..................................... Foundation .................... Prop. line ............... REPAIR/ADDITION(Prey. Sanitation Permit# .....15425.................. ....... Date . .2,.7..:b3 ...... Septic Tank (Specify Requirements) .............31.40t,14g........ ..............................................................—.........._................. Disposal Field (Specify Requirements) ------Sy P -lhainagas--•--.lIVx2E Wide ----- 1 Diversion Box ------------------------------- ---.... 1 3az5t seepage p............ ..................... (Draw existing and required addition on ----••---•--••.................. ..... ................. ......••--•--• •-revers-----•- e side) I hereby certify that 1 have prepared this application and that the work will be done M accordance with Son Joaquin County Ordinances, State Laws, and Rules and Regulations of the San Joaquin Local Health, District. Home owner or licen- 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 in such manner as to become subject to Workman's Compensation laws of California." Signed ._.-.--D. A. PARRISH & S S C --------------------- -•- -- BY . .- - --- ---------- _._ Title __.estimator -- ---_- (If other than owner) ----------------- ------ FOR ---- - _._ FOR DE ARTME T US ONLY APPLICATION ACCEPTED BY ------ - J ....... 1.. DATE . ✓. "; / BUILDING PERMIT ISSUED --------- ....... .---•-•-- ------•- ------ --- -----------------..-- ._DATE . ADDITIONAL COMMENTS -------------- •--- - .- ----._ .... -- ---- ----- - ---- .. -- - .. ................I...... Final Inspection by: . - - - -- - .. .rte. {} -- - -•-- ..--- ...... 1C.... Date ..-lc�!'.. l..�o_. EH 13 2c{ 1-68 Rev- 5M . . .... ...... _ r. _. SAN .IOAQUt L�AL HEALT i CT 8/7h 3M