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APPLICATION EOR SANITATION ERMIT Permit No. <br /> b (Complete in Duplicate) <br /> Date Issued <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 /> JOB ADDRESS AND LOCATION....-__z3- West 6th. Street, Stockton <br /> Owner's Name------------ George W'- Stiner_ <br /> -- -------------- --Same <br /> ----------------•----------------------------- ------------------------------------------------------------------•------------------------------ ----•---------------------------- <br /> Contractor's Name----------------------------------D,__- FA, I,ciH & SON. INC. <br /> ------------------------------------------------------- Phone_-9.--q6Q7 <br /> --------------- <br /> Installation will serve: Residence M Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: 1_____ Number of bedrooms 1----- Number of baths __1__ Lot size ___So! X10©.t_________________ <br /> ------------ <br /> i <br /> Water Supply: Public system.] Community system ❑ Private ❑ Depth to Water Table -------- ft. <br /> Character of soil to a depth of 3 feet: Sand Gravel Sand Loam Clay Loam Clay Adobe Hardpan P ❑ ❑ Y ❑ Y ❑ Y ❑ ❑ p ❑ f <br /> Previous Application Made: Yes ❑ No A New Construction: Yes ❑ No ❑Addition <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_NTone----Distance�from foundation__ - R________.Ma erigl__ "�'-__B Brick <br /> ------------ <br /> ] No. of compartments--------2-- ----------Siz $ OD X Liquid depth____------2_____________Capacity------ CdGa�.s 1 <br /> foundation <br /> loo t <br /> Disposal Field: Distance from neares�well_N021@-___Distance from founda�o��'_________ Distance to nearest to Inne______ ________ <br /> KI Number of lines--------------14- ---FfIL_--Length of each line...............z8p______.Width of treneh-o- -----------------------.---- <br /> Type of filter material______________ ____Depth of filter material--------__---_-_-------Total length__--_______ __-.___ ---__._________ <br /> Seepage Pit: Distance to nearest well----------------------Distance from foundation___________________.Distance to nearest lot line----------------- <br /> El Number of pits----------------------Lining material-----------------------Size: Diameter------------------------Dept h-------------------------------.- <br /> Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material-------------------------------------- <br /> Extpting ''Size: Diameter-------------------------------------- _______Li Liquid Capacity <br /> --------------- Depth----------------------------- - ---------- q ----------------------•-•---gals. -, <br /> Privy: Distance from nearest well-------------------------------------------------Distance from nearest building-----------.------------------:_______-__..-, ¢ <br /> Distance to.m3arest to#_line.-_�-- ________________-__ <br /> Remodelin an or a airi des ri e :___-_Parrish to construct 600 gal ca 2 CoT. t Se tic <br /> (-­------------------------- hY p <br /> .......aid__._-D inn o --,c 5x�---drain__which-will empt-----into the existiz <br /> cesspool ' ` li__•-- 'is occupied- - - -� n P - � <br /> �-------------- --b ---o e erson__ only <br /> ------------------------- <br /> ------------------•----------------------------------------------------...-'-------------------------------•------------------------------•---------------------------------------------------------------------------- <br /> I 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 /> (SignSi ned A. PARR SH &_ SONS j, INC.. - ---------' - ----------------11-----------------�"�r Contractor) <br /> ed)----4sing <br /> ��---------- -BY: Estimator <br /> (Title)---(Plot Ian, size of lot, location of s!sfe7i)nrelation to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY--------- DATE. - .- -- - --------------------------- <br /> REVIEWEDBY--------------------------------- ---- ------- -- ---------------------------------------------------- DATE------- <br /> BUILDING PERMIT ISSUED---------------------- DATE <br /> Alterationsand/or recommendations--- ------------------------------- -------------------------------------------------------------------------------------------------------------------- <br /> --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------- <br /> FINAL INSPECTION BY:---- Date---------� 1 <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130, South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California 5 <br /> { <br /> ES-9-2M 8-51 Revised W-2100 <br />