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--77 �c� APPLICATION FOR SANITATION PERMIIe` Permit No.� l- 0 Qi 5 (Complete in Duplicate) Date Issued 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--------------- West 6th, Street-. St®ekt®n ------------------------------------------------------------ Bunest Bundy -------------- --------- Phone----2-`-'-7 '38-------------- Owner's Name------------------------------------------------- ••---------------------- _ 917 E. Weber Avenue Address______________ --D- A----pARRISH & SONS- INC• -------------- Phone-------9-a6Q7---------- ----------- Contractor's Name-------------------------------------- ---------------------------- ----------------- -------------- Installation will serve: Residence [X Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: __� Number of bedrooms __3___ Number of baths -----___ Lot size __�6 t��r�t Water Supply: Public system Community system ❑ Private ❑ Depth to Water Tablea_f- plus Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam-[] Clay ❑ Aclobel Hardpan El Previous Application Made: Yes ❑ No Pq New Construction: Yes r] No ❑Supplementary drainage {� TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well-----------------Distance from foundation--------------------Materia4------------------------------------------------- ia --------------Liquid depth--------------- - -- P Esting No. of compartments--------------------------Size_----------------- __Ca Capacity ---- „ Z_ Disposal Field: Distance from nearest well------------------Distance from foundation--------------------Distance to nearest lot line________________ ETAstirng Number of lines-----------------------------------Length of each line------------------------------Width of trench------------------------------:_-- Type of filter material-------------------------Depth of filter material------------------ ---Total length-------------------------------.---------- Seepage Pit: Distance to nearest well---140"'*---- Distanc �Co foun ation_�'©.............Disyjj a to nearest lot I--ng_t ______-____ Number of pits- ------------- ---Lining matarial_ _ Ill ``__ ri'CAize: Diameter----------- -----Depth----------- ----- ----------- Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material-----------------------------._______- ❑ Size: Diameter---•----------------------------------Depth----------------------------------------------------Liquid Capacity--------------------------..gals. - _-_Distance` r0m'rsearest buildin"`- � . T __- -Privy: _..:... •Distance"from`neare�sf�weil------------ ----- ----------= 9----4--------�_,.:--------- -------6 : ❑ Distance to nearest lot line------------------- ---- -------------------•-----------------------------------•--------- , } Remodeling and/or repairing (describe):------------------------ ----------------------------------------- ----------------------------------------------------------------------------------- .. ------------1---------------------------------------------------------------------------------------------------------------..................--------------------------- 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 PARRTSH & S4NS s INC,.... ��Contractor) EstimaLtor 1 By----- - --------- ------------------------------------------------(Title)--- - - - --------------------------------------------- (Plot ------------------------------------------- (Plot plan, A Ing size of lot, location of system i relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY___________ ___ ____ ___ _ DATE----_� ___— - - ---------- - -------------------------- REVIEWEDBY-------------------------------------------------- ------------------------------------------------ DATES BUILDINGPERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE------------------------------------------------------------- Alterationsand/or recommendations:--------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------- �I -------------------------------------------------- ------------------------------------------------------------------ -------------------------------------------------------------------------------------------------------------------------------------------------------- —--------------------- FINAL INSPECTION BY: - -------- -. Date - .-, F SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California E$-9-2M 8-51 Revised W-2100