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7 — APPLICATION FOR SANITATION PERMIT Permit f (Complete in Duplicate) Date Issued Applicl_ Is ereby 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. 2953 South Odell -Street s---Stockton------------------------------------------------------ JOB ADDRESS AND LOCATlON__._------------------------------- ------ Arthur B. Cesena --------------------------------------- Phone---3_'"5_287---------------- Owner's Name-------------------------------------------- — - --- ----------------- ------------------------ 1329 Scotts Avenue Address-------------•-------------------- ---------•---------•-----------•------------------------------ ----------------------------------------------------•---------------------••-------- --------------------- D,, A. PARRISH & SONS s INC- ------------------- Phone__.g�'960'l-___----_--_--- Contractor's Name_________________________ ------------ ----------------------------------------------- Instaflation will serve: Residence 0 Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑1/2 AOther ❑ Number of living units: _ ____ Number of bedrooms 3.__ Number of baths ____ _ Lot size --------- -----=------------=-------------- ------------------ Water Supply: Public system ] Community system '❑ Private ❑ Depth to Water Table 28" ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ ,Clay Loam [IClay ❑ Adobe [ Hardpan El Previous Application Made: Yes ❑ No EX New Construction. Yes ❑ No ❑ Replacement TYPE OF INSTALLATION AND SPECIFICATIONS: I� (No septic tank or cesspool permitted if public sewer is available within 200 feet. CC BrIek Septic Tank: Distance from nearest well---��_-------Disf-v—.p ��f ndatioq----'�--_p--•-•.M8#y�ial--------------------- 1 4_,_G 1 2 b b - _ __Li Liquid de th_-_.�--------------------Capacity------- - ® No. of compart ----- tt 'IQ t 6p t 7D thee ---__1Q T-____Distance to near lin _ Disposal Field: Distance from nearest well_________________Distance from fouund El 10 ® Number of lines-----. -Length-of th..of each line---------- ----- Width of trench,- ------------------ tr--Rk- --Total length Type of filter material-------------------------De th of filter;inatersal__-____40�-----• g i h Distfince to nearest�l�o�t li�r e__1Q Seepage Pit: Distance to nearest well IN-----__pistance from foundafiion______________ _ X�6i7W 18"T------ }n Number of pits----- --------------Lining material_C'_ _--BrickSize: Diameter____33-- ---------Depth--------------------------------- rL Cesspool: Distance from nearest well----------------_Distance from foundation__..__---_.______._.Lining material-------------------------------------- ---------- ____________________-____________--. v - -----= ---_�LYJuie�,Capafi>+ Size: Diameter Depth ---- ----------------- El , ,,-,, - „�.� •-��- --y pistance from nearest building________- ____ Privy: Distance i:rom nearest well_----------------------------------------------- Distance to nearest lot line--------------------- ------ - ---------------- Remodeling and/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, k ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. Si ned _ D. A. PARTRISH s01,� ZhiC- ( �C�ontractor) (Signed) Estima or ---------- -------------------------------------------------------------et .-------- Title --- -- - - -- - � y"---""--------------- - - � buildings, etc., can be placed on reverse side]. I (Plot plan, showing size of lot, location of system in relation to wells, FOR DEPARTMENT USE ONLY 1 �' APPLICATION ACCEPTED BY---------------------- -- --- ------ --------- -------------------------------------------- --- DATE--- -- ---r--�--`-� ----�----- ------ -�-� REVIEWEDBY---------------------------------------------- ---------------------- DATE------------------- --------------------•------------------- DATE--- ------------- - BUILDING PERMIT ISSUED------------------------------------------ ---------- Alterations and/or rECOr7lnlenddt10n5____________ __ ------------------------------- ----------------------- --------------------------------------- -------------------- - ------------ 1 ----------------------------------- -- ---------------------- ---- ---------- FINAL INSPECTION BY:--------- Date ` SAM JOAQUIWLOCAL HEALTH DISTRICT 300 West Oak Street 132 Sycamore Street 814 North "C" Street 130 South American Street TracCalifornia Stockton, California Lodi, California Manteca, California Y ES-9-2M 8-SI 'Revised W-2100