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APPLICATION FOR SANITATION PERMIT Permit No. _✓_3_p____.___- (Complete in Duplicate) 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-corn Bance with County Ordinance No. 549. � -. f Linden, Calif Rt, 1 Box 168 Linden: Sam caer of Bonham & Front 5t.1 JOBADDRESS AND'LOCATION.. •---- - - ---- ------------------------------------------ -•----------------`------------------------------------•--------------------------------------- John De Martini xj -. 09lo�j Stkn 2-2947 Owner's Name-------------- - - .---------------------------------------------------- Phone Address•-•... Sairie z 1 PARRISH INC., . Phone__.. _ 96C7 Contractor's Name_---------------------------- - --- -------- ---------------------------- ----- --------------••-v- --� Serv- na ; Installation will serve: Residence [X Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other9 Self L r Number of living units: _-____._ Number of bedrooms --____._ Number of baths -______ Lot size _______62_Tx141Tx53T Lot , Water Supply: .Public system N Community system E] Private ❑ Depth to Water Table__._T__. ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑, Clay Loam ❑ Clay [I Adobe ] Hardpan ❑ I Previous Application Made: Yes C? No ❑ New Construction: Yes [N No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) r Afore 101 CC Brick Septic Tank: Distance from nearest v�ll___:____'_______Dlst�% frn foundation__________________lv]•ajWia1-___._________..________..__-804----------. \:fm ,� No. of compartments Size it- Liquid depth------- ---- ------------- Capacity---- --------------- EX p deep rDisposal Field: Distance from nearest well--------------____Distance from foundation________--_._____._Distance to nearest lot line----------------- ❑ Number of lines----•------------------------------Length of each line-----------------------------Width of trench----------------------------------- , Type of filter material_________________________Depth of filter material-------- . ._Total length---------------------------- _ ______ . T Seepage Pit: Distance to near t well......�T — Distance from foundation___-l�__----___.D�s�ce to nearest Iijbi♦ne----------------- a ------.Lining material-CC---BriC Ize: Diameter---------------- ---Depth---------- ---------------------- Z [� Number of pits--------__ -- --- - Cesspool: Distance from nearest well__._____________Distance from foundation---___--------------Lining material____________..____._________.______ ❑ Size: Diameter- --------- --------- ----Dept h------------ -- ---- -- ----- -Liquid Cap�aty ---�-- _ y�gal$, Privy: Distance from nearest well______ .---------------------------------------.-Distance from nearest building-------------------------------------------- F1 -- __..__.__ _ ________-.-- ._.❑ Distance to nearest lot line--------------------------------------------------------------------------•-------------------------------------------•--------- — This constitutes settling tank or grease trap for Remodeling and/or repairing descrifee)----------------------------- ------------ ---- ---J, Serve Your Se�f Laundry starting wi th machines v?ith inaxiinum of at - - -------- --------------------- ------------•--- ------- ---------------------------•------ ----------- _ future date. . ,. L�ds are reinfore�d. • �r -------------- --------------- ------------------ -- ----------------------------- --•-------------------------------------------------------------------- ------------------------------------ ------------------------•----------------------------------------------------------------------- ------------------------ --------:----------------------------------------------------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County j ordinances, State laws, and rules and regulations of the San Joaquin Lo al Health District, f PARRISH IL N . . Contractor (Signed)------------------------------- ----------------- ---- ---- -•------------ ---------------------------------------- ----------Esti�mato BY: - _ r --------- = ------------------(Title]------------------------------------------------------------- - 1` (Plot plan, showing size of lot�ocation of stem in relation to wells, b dings, etc., can be placed on reverse side). FOR DE_P_ARTMENf USE ONLY APPLICATION ACCEPTED•BY------------- ------------- ----------------------- DATE-=---- � ;�- ---------------- -- REVIEWEDBY ----------------- DATE----------------------------------------------------------- BUILDINGPERMIT ISSUED--`---------------------- --------------• --------------------------------------------------- ------- DATE.. t -- - ------------------------------------------------------------------- ------------------- •- ------------ Alterations and/or re commend ation�s:`A . . ..... '- 3, ----- ----- -------------------- ----------- ----------- ----------------------------------•------------------------- ----••----------------- - -•-----------•---------------------------------- -------------------------- --•------------------------------------------ ----------------------------- --------------------------------- --------------/ FINAL INSPECTION BY------------------- --------- ------ Date--------- — --------------- t SAN JOAQUIN LOCAL HEALTH DISTRICT 130 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 10-52 Revised W-2100 .,