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1lr WWI APPLICATION FOR SANITATION PERMIT 6Permit N [Complete in Duplicate) Date Issued %211 - 1 • �. ' ____ _____-- 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-----------2052 Orwood Ave,--_.-. .. Stockton-------------------- ------------------------------------ Owner's Na'rne-----------------------------------------F+'rCd E. '�iIDg1CrBtiLn------------------- --- ----------- ••rj}.�+4 ---- Pho --------------- ---------------- Address-- ------------- Same D. A. PARRISH AND SONS INC, ContractorsName--------------------------•-------- -•-------------------•-------------------------------------------------------------- Phoneg-------------------------------- Installation ----- -- ------------------ • p ❑ ❑ Trailer Court ❑ Motel ❑ her ❑ InstalEaNumber of living unlits:n ___ Numberofbedrooms _ ___CNumber lof baths __ Lot siz -6�f-_a- Za.Q--! ____ � / : , . , � . i Wafer Supply: Public system Community system 0 Private E] Depth to Wafter Table___ ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe)g Hardpan ❑ Previous Application Made: Yes ❑ No7 New Construction: Yes ❑ No ❑ Supplelentary drsmnage TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 280 feet.) t Septic Tank: Distance from nearest well-----------------Distance from foundation----____-----------_Material_.------___________________________________-_. ExINting No. of compartments--------------------------Size--------------------------------Liquid depth--------------------------Capacity----------------------- Disposal Field: Distance from nearest well_________________Distance from foundation--------------------Distance to nearest lot line_______________- EXLSting Number of lines-----------------------------------Length of each line------------------------------Width of trench----------------------------------- Type of filter material_____--------------------Depth of filter material-----------------------Total length-----------------------------------------. See a e Pit: Distance to nearest well--3'00 Distance from foundation;'1__________.D' ce to nearest lo�I _____7*__.-__ g Number of pits-----:k_____________Lining material---------------------Brie: Diameter_____�� -_______Depth______._-��_ ---------------- 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------------------------------------------ nDistance to nearest lotline-------------------------------------------------------------------------------------------------------------------------------------------- Remodeling and/or repairing (describe):----------------------------------------------------------------------------------------------------------------------------- •-------••-------- -------------------------------------------------------------------------------------------•------------•---------------------------------------------------------------------------------------------------------------- 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. A e P S A SONS s INC . . Contractor (Signed).._.---------- I ) - ------ ------------------- ---------------------------------------------------------------------- Title Estimator By:.....-- ------ ----------------[ • )----- ---------•-------------------------------- (Plot plan sh i size of lot, location of s e in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATIONACCEPTED BY(2 ------- -------------------------------------------------------------------------------- DAT E9S-------------------_------------------------------- REVIEWED BY ---- ---- ---- DATE ------------------- -------- --- --------------------------------------- BUILDINGPERMIT ISSUED-------------- -------------------------------------------------------------------------------- DATE--------- ------ ----------------------------- Alterationsand/or recommendations:---------- ------------------------------------------------•-------------------------------------••----------------1-- --•-------------------------------- ---------------------------------------------------------------------- ------ --------------------------------------------------------------------------------------------------------------------------------------------- -------------------I---I-------------------------------- ----------------------------------------------------------------•--------------------------------—----------------------------------------- ------------------------------------------------------------------------------------------------------------------------ ------------------ - ------------ - ---------------`------•---------------------------- ------------------------ ---------•-------------------------------------•---------------------------------------- A�p s..d . FINAL INSPECTION BY:- I mss'`' x - -------------- Date----t"`— -/ ---`-- --- SAN JOAQUIN LOCAL HEALTH DISTRICT 5 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California. Manteca, California Tracy, California i E5---9-2M B-51 Revised W-2100