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. Od APPLICATION FOR SANITATION PERMIT (Complete in Duplicate) 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------------------------------23 Porter Ave.--------Stockton, Ca ------------------ -------------------- 3- 5209 P�Sr. JaC� Allen----Allen---- - ---------- - ---------------------------------------- Phone----- ------------------- Owner's Name---------------------------------------- -----------------------W----------- - - - 723 Porter Ave. Stockton Cal. ----------------------------------- Address---------------------------D---- ---------------- i--------- 8-8597 D.A� Farr .sh & Sons,-- Inc- Phone------------------------ - ------------------------------------------ Contractors Name------------------------------------ --•----------------- -- --------------- ---------- - Installation will serve: Residence EX Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ r 1 Number of living units: -M Number of bedrooms a Number of baths Lot size---_---2Z_�____-X---20_______________________ Water Supply: Public system ❑ Community system ❑ Privafe 1pl Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ] Hardpan ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) from foundation.-------------------- Z�l Septic Tank: Distance from nearest well-----------------Distance, -Liquid depth-------------------------- ❑ r No. of compartments------------------•-------Capacity.--------------------- Size n Cesspool: Distance from nearest well-----------------Distance from foundation_-_-______-_-----__.Linig material---_--___--____- ❑ Size: Diameter--------------------------------------Depth---=------_--------------------------------------- Privy: Distance from nearest well-------------------------_____-_. --------------Distance from nearest building------------------------------------------ ❑ Distance to nearest lot line______________________ ________________________ # ' { s i Seepage Pit: Distance to nearest well---�-�d_-_-__-_-- Distance from foundation__-_34-1---__-.Distance to nearest lot line----------------- on. BrDiameter d Ex Number of pits--------OYle-----Lining material--Q---- ------------ Size: Diameter--- ��--------- -----Depth---- -------------- - 51 Disposal Field: Distance from nearest well----5Q-;------Distance from foundatio ------ f-----------Distance to nearest log line--�-- -___--- Number of lines-------O �-�f r'OC3� Length of each line-__68.......................Width of french--_24----___----------------- Type of filter material--- -------------------Depth of.filter material-- --------------- Relacerzent of Drain ----------- ----------------------------------------------- Remodeling and/or repairing (describe):----- - P - ----------------------- -- ------------------------------ ----------------------------------------- ------------------------------------------ - - ----- ----- - ------- ------- ----------- - 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. (Signed}_ D.A. Parrish & Sons_, Inc. ` - - -------- -- ---------------------------Owner and/or Contractor) ------ Miles A. Parrish- Title---------- e-------------------------------------------------- sY:--------------- -- - ) ---------------------------------------------------------------- - -- (Plot plans, showing size of lot, location of system in relation to wells, buildin s, etc., must be filed with this application). FOR DEPARTMENT USE ONLY DATE---------------------- ------------------------- APPLICATION ACCEPTED BY---- Y �j -- - ------------------------------------------------ DATE---------------------------------------------- REVII=WED BY------------------------------------------------------------------------ - - , BUILDING PERMIT ISSUED------------------------------------------------------------------------------------------------------ ---- ----------- ------ ---------- DATE------------------------------------------------------------- - Alterations and/or recommendations----------------- ----------- ------------ --------- ------------------------------------------ ----------------------------------------------------------- 3 v a'l l' y ---------- Date FINAL INSPECTION BY:. ---------------------- PERMIT No._/�---------- -------- ISSUED---- - ^� - � ----� 7 . Date----------------------- ��-I-'�--- - ------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT I 130 South American Street a Stockton, California ES-9-21A 9-50 W=1639 _