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r � � 'No. APPLICATION FOR SANITATION PERMIT Permit --.10D _ (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 compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION----------ChinChiolo" Packing Shed--North Broadway'------- --------- -------- ---------- 1 Owner's Name-------•---------------• C�'1in hl0 0 Brothers -------- ------ ------------- ---------------------- Phone----"--------------•---------------- Address--------------------------------------15 6 west--Willow----- -------------------------------.. .'--------------------------------•------------------------------ ------ Contractors Name------------------PTI' Sh--&".S13C2SI2Ca Phone.gC.-67:�g6Q7 Installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: -------- Number of bedrooms ----- -- Number of baths -------- Lot size ...... Creagq_•---______________________-___._ Water Supply: Public system ❑ Community system ❑ Private Etc Depth to Water Table __1f:5 ft. , Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ❑ Hardpan ❑ Previous Application Made: Yes ❑ No IN New Construction: Yes EX No ❑ 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 well_�0_---------Distance from foundation- _-1Q_"-_-.Mate ial---- C C Bri ck 6== t 2000 al ® No. of compartments-- 3-----------------Size-----•5---------------•-------Liquid depth--------5 -------------Capacity-------------------g-- `o _ 1, Disposal Field: Distance-from nearest well-----5pt-=-._Distance from foundation -_-_�-� -_--__Distance to nearest q =Iine...Jr-..--.-- ® Number of lines-------2-------------------------Length of each line------QO-_--_----5o.-.Width of trench"_ ---_-----------_-.--------.--- Type of filter material---S.__S'0C_k.---Depth of filter material-----!8._.__.--..Total length_--- ��-------------------------- _-• „ Seepage Pit: Distance to nearest well -__100' ---Distance from foundation---_10------_--.Dista nce to nearest lot i��---------------- ----------- 5� . ® of pits`--- ------------- LinEng material--------?-QCk--.Size: Diameter-___3-3--- Depth-.----"2� ------- Numberj 1 Cesspool: Distance from nearest well- -------------=-Distance from foundation---------------------Lining material--..---_.-..___.----.-._- [� Size: Diameter = - ------- ------------------Depth-------- ------- ----------------------------------Liquid Capacity----------------------------gals- Privy: Distance from nearest well---.-------,__-- ----------------------------------Distance from nearest building------------------------------------------ f l ❑ Distance to nearest lot line=-------- �'=---- --- ------"- ----------------•---------- I Remodelingand/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. ' Parrish & Sons Tnc - -- � ' - Owner and/or Contractor [Signed)-----------••---•--------------------------------- - - ( � � By:----------------------------------------------`--- B-11LFII' ght -----------=--=----------------------(Title)----- E_SA----.--------------•--------------------------- (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 BY---- -------------7----------------------------------------- ------------ DATE---------�(=ty �� --------------------------- REVIEWEDBY--------------------------------------------- --------------------------------- ------- --------------------------------------- DATE----- -•---"-------•-------------------------------------- BUILDINGPERMIT ISSUED----- -------------------------- -----------------...-----------------------------------. -. DATE.-----------..------•-----•-;7---------------------------- Alterations and/or recommendations:-----/50--------41;�IqC q------Q-I --=---------------------- -------------------------------------------f--- ---------------------- -------3-3 )0 2' � � _-----•------------ ---- ------------- • • -- ----------- ---- �---- -• -�- I i 7"+I .. (N _�N�_.---Qt=------5F1?:1_1C.,....T.t 9_***---- --�_ - R= ' ...... ---------- ---------------- " M------- ------- _ Q€ -------5.1-Ft's(-------�.P T�.''-EJ.K CMn[ - Tftl� - -- - -- ------------------ FINAL 1NSPECTI6Y:. _ Date--....-------=- ---- _�------------ - 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----9-21vl Revised 1.57 F_P.CO. 1