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APPLICATION FOR SANITATION PERMIT i (Complete in Duplicate) i 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------911 Beatrice,-- StOokton-------------------------------------------------------------------------------------------- Owner's Name-------------Virginia Lo Morris _ Phone-- �6�10----- __ Mo ------------------------- ------- � ---------- ------------ - -- ----------------------------------------------------------- - - ---- -- - Address_____i_ 911 Beatrice ------------- Contractors Name___________D,---A._-_._Parrish 8---Son-s-0----Inc� Phone 9--9-60-7--- --------- Installation will serve: Residence 13 Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: Number of bedrooms ?I Number of baths [I Lot size----50_'=Q-1------------------------------------- Water Supply: Public system Community system ❑ Private ❑ Character of soil to a depth of 3 feet: Sand ❑ *Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe[3 Hardpan E] TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well-------------------Distance from foundation_____=_________---Material_-_-________-__-____---_____________________ ❑ comp . No. of compartments--------------------------Capacity Ca acit ------Size-----:--------------------------Liquid depth--------------------------. Cesspool: Distance from nearest well-----------------Distance from foundation-------------------- Lining material______________________________________ ❑ Size: Diameter--------------------------------------Depth---------------------------------------------------- Privy: Distance from nearest well-------------------------------------------------Distance from nearest building------------------------------------------- F1 Distance to nearest lot line------------------------------------------------ • r 5r Seepage Pit: Distance to nearest well-----X91W-----Distance from foundation_----�----------Distance to nearest lot li [ Number of pits________`--__1_____Lining material_ iC"_C_'_ogq,: Diameter_-.-_-33__________Depth----___2 __________.___ Disposal Field: Distance from nearest well------------------Distance from foundation--------------------Distance to nearest lot line----------._____=F ❑ Number of lines-----------------------------------Length of each line------------------------------Width of trench----------------------------------- Type of filter materia4-------------------------Depth of filter material----------_------------ Su l went to existing drainage system; ; Remodeling and/or repairing (describe)=-------- ------pp ------------------------------------------------------ - ---------------------------•------------------- ----------------------------------------------------- hereby certify that 1 have this application and that the work will'be done in accordance with San Joaquin Coun�y ordinances, St to laws, and rules and regulations of the San Joaquin Local Health District. D H & SONS INC: : : , (Signed) - ----- --- - -------------------------------------------------- ( $r� L`ontractorj ----- --- --- i Title Es .motor---"------------------------ By:-------- ......... ---------- - ----------------------- ( } (Plot plans, sh ing size of lot, locationofsyst in relation to wells, buildings, etc., must be filed with this application). FOR DEPARTMENT USE ONLY _APPLICATION ACCEPTED BY------------ ---DATE----------3----- --- -�--------- REVIEWED BY------------------------------------------------------------------ ---------------------------------------------------- -- DATE---------------------------------------------- ------------ BUiLDINOPERMIT 155UED----------- -------------- DATE------------------------------------ -- ---------- -- Alterationsand/or recommendations---------------- ------------------------------------------------------------------- -------------------------------------------------------------------- ------------------------------------------------------ ---- ---------------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ -------------------------------------------------------------------------- --- ------- ------------------------------------------------------------------------------------------II----------------------------- ------------ PERMIT No-----i-}-�^- ------- ISSUED__ '- - -------------(Date) FINAL INSPECTION BY:----------(1l_I_-�,,V___II --------------------------------- Date_ - r �' '" `r SAN'JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California ES-9-2M 9-50 W=1639 f