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APPLICATION FOR SANITATION PERMIT­ <br /> (Complete in Duplicate) <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> MM <br /> JOB ADDRESS AND LOCATION--------------- x+29 N. Shasta Ave.--- -------------•------------------------------------------------------------------------------------------------------------------ <br /> Owner's Name------------------------`7.E._-Su_t-oh n <br /> ---------------------------- --- ------------ -------- --------- ------ Phone-- �—�-��---��----•------- <br /> ---------------------- <br /> Address---------------------- 429 IT. Sh`--qty' Ave. Stockton, Cal. <br /> - - - ---------------------------------------------------------------------------------- - ----------------------- <br /> --- -- ------------- <br /> Contractor's Name_______________DD.A. Parrish & Sons. Inc. �_:a <br /> ---------------------- ---------------------- 597 <br /> Phone <br /> Installation will serve: Residence [?I Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: F] Number of bedrooms � Number of baths [4 Lot size-___ <br /> Water Supply: Public system ❑ Community system ❑ Private E <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe 12r Hardpan ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well-----------------Distance from foundation-------------------.Material____--_-___--_-EJ <br /> ------------------------- <br /> No. of compartments---•----------------------Capacity-----------------------Size--------------------------------Liquid depth-------------------- <br /> ----- <br /> Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material----__---__------- ____-_ <br /> ❑ Size: Diameter--------------------------------------Depth--------------------------------------------------- <br /> Privy: Distance from nearest well-------------------------------------------------Distance from nearest building <br /> ❑ Distance to nearest lot line_________________________________ <br /> Seepage Pit: Distance to nearest well------ ------Distance from foundation----Z ----------Di 1tance to nearest lot line= _--__-____-_ <br /> IN Number of pits--_.-Qn --------Lining material_{!Dn• 3�`�ize: Diameter---33_--___------ 2._ <br /> - .Depth------------5------------------ <br /> r r r <br /> Disposal Field: Distance from nearest well------- ----Distance from foundat4'?n _x_30.--___---.Distance to nearest to line__8---_.______. <br /> IN Number of lines-- One Length of each line-----.f__-�-__-----h_-------.-.Width of trench---241------------------- <br /> l� rock l2 <br /> Type of filter material_--� -------_Depth of filter material <br /> and/or repairing (describe)--------------_____--------Aclt ition_---O--drj_nvG system <br /> Remodeling <br /> -------------------------------------------•---------------------------------------,--------------------------------------------------------------------------------- ----,-------------------------------------- <br /> hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> (Si ) D.A. Parrish Soris, Owner and/or Contractor) <br /> 9ned <br /> gy� 4� - - ------------ -- - . - - - -----•------ (Title)-----President- <br /> ----------------------------- <br /> (Plot plans, sha�inggsizeof lot, location of syste, in relation to wells, buildings, etc., must be filed with this application). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY----------- <br /> ------------ DATE <br /> REVIEWED BY------------------------------------- ---- ---------------------------- DATE------lQ b 5-0 <br /> ------------------------------ <br /> ------------------------------- <br /> UILDING PERMIT ISSUED--------------- --------- --------------------- ------------.. DATE------------ <br /> -- <br /> Alterations and/or recommendations___________________________________ <br /> ----------------------------------------------------------------•------------------•------------------------------------------ <br /> ------------- ------------------------------------------------------------------------------------------------------------ <br /> PERMIT No.----__�_(----_------- ISSUED---- 3- ------------------(Date) FINAL INSPECTION BY:------4I--v- ------------___-- <br /> Date------------•--------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street <br /> ES-9-2M 9-50 W-1639 Stockton, California <br />