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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 /> 5 5 S e s t 6 t h...... Stockton.......cal.--------------------------------------------------- <br /> JOB ADDRESS AND LOCATION-------------------------- - ---------------------------- <br /> z.-656a <br /> LacaroT. Re suil.lo ------------------------- ---------------------------------- Phone <br /> Owner's Name_----------------- - ---- - - -- - - - ---------------- <br /> 555 <br /> ------------ <br /> 555 West 6th. , Stockton, C a1' --------------------------------------- -------------------------------------------- <br /> Address------------- ---------- -------------------------------- €3-8597 <br /> --------------------------------------------- <br /> D.A• Parrish & Sons, Inc- ailer Co <br /> , --------------------------------Motel one---Other 0 <br /> Installation <br /> Installation will serve- Residence [T Apartment House El Commercial X <br /> Te- 1--- --1-❑o`•--d-1 -------•-- 1 <br /> Number of living units: M Number of bedrooms P1 Number of baths•] Lot s <br /> Water Supply: Public system N Community system ❑ Private ❑ <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam❑ Clay ❑ Adobe ] . Hardpan ❑ <br /> TYPE OF <br /> 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 e.___..___________Material ------------------------------------------------ <br /> Septic <br /> depth-------------------------- <br /> Cesspool: <br /> ...........--- ------ <br /> ❑ No. of compartments----- --------------------Capacity----------------- - <br /> Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining materia------------------------------------- <br /> F1 <br /> _--_-----_- --_❑ Size: Diameter--------•-----------------------------Depth---------------------------------------------------- <br /> Privy- <br /> -------------------- -----------------------------Privy: Distance from nearest well--------------------------------------------.----Distance from nearest building ------------------------- <br /> Distance to nearest lot line------------------------------------------------ t <br /> lone . 20 r----- i <br /> Seepage Pit: Distance to nearest well----------------------Distance from foundation-59 to nearest lot line_.--___-_ <br />{ Number of pits----.One--------Lining material_C'0 - -13 r aSize: Diameter--- ---------------Dept P.r_--ax------------------ - <br /> ,Disposal Field: Distance from.nearest well-__ off--Distance from foundation-l----------------Distance..to-nearest40 to line -:..--__-- <br /> t <br /> Number of lines___ ne- "-------------------Length of each line__-_-�-_-_-___-----------Width of trench---____-_"-_-__"---_"--__- <br /> Type of filter material41_"­: --T'0Ck_-Depth of filter material---- 2i------------ <br /> a <br /> addition to drainage---B_y__s ten ----------- ---------•------------------••-------- <br /> - ----------------------------- <br /> Remodeling and/or repairing (describe):_____________________"_----"--.-- <br /> ------------------------------------------- <br /> ------------------------------------------------------- <br /> -- - ------------------------------------------------------------------------------------------------------------------------ <br /> ---------------------------------------- ------------- -- -- <br /> f ordinahereby cer ify that I have end regulations Ili the San Joaquin nh work <br /> HealltheDistrlct� accordance with San Joaquin County <br /> ate <br /> ' D A Parrish & Sons, Inc. --- ----------- -.--- r Contras <br /> Si ned <br /> D.A. -- <br /> (Owner and/or fir] <br /> ( g --------------•-------------------------------------------------------------- _ President <br /> MilesA- Pa r'ri • --(Title)----------- - - ---------------------------------------- <br /> Sy:---•-------------------•- ----------------------- ------ <br /> - ------- --- - - <br /> (Plot plans, showing size of lot, location of m in relation to wells, buiidin s, etc., must be filed with this application). <br /> FOR DEPARTMENT USE ONLY <br /> z �-' 7'-- -~------------------------------ <br /> -- DATE--------------------- _ <br /> APPLICATION ACCEPTED BY------- ---- - ----------------------- ------------------------------- <br /> --------------- <br /> REVIEWED BY----------------------------------•-------------------------- <br /> --------------------- ---�---- --------- -------------- DATE--------------'--�---�--a----------------------•--- <br /> ' -------=--------------------•-•- DATE--------•------------ -------------------------------------• <br /> BUILDING PERMIT ISSUED----------------------- ---------- <br /> ] Alterations and/or recommendations---------------------------------------------------------------------------- <br /> ----------------------------------------------------- <br /> ----------------------------------------------------- -----------------•------ ------------------------------------------------------------------•---------------- <br /> PERMIT No-----}__-S`(--_----_-- ISSUED----- - ".``1_`-S c -"-- (Date) FINAL INSPECTION BY A <br /> �_ -40_v---------------------- <br /> - - ---------- <br /> 1 <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street <br /> Stockton, California <br /> E5-9--2M 9-50 W-1639 <br />