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W <br /> 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 /> JOB ADDRESS AND LOCATION_______1-786__V1.____Sonora _Street, Stockton <br /> Owner's Name Al'oer-- -'1.--PO k -------- - ----------------------------- Phone------------------------------------ <br /> ----------------------------------------------------------- -- - <br /> 178b W. Sonora Street <br /> Address - ---- --•---• ----- ----------------------------------------------------------------------------------------------------------- <br /> Contractor's Name---------D...... ...... .ARRISH-&---5�h15- -...�IdC+------- ----- ------------- 0------------- ------ Phone----8-8597------------ <br /> Installation will serve: Residence)=Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: ❑1. Number of bedrooms Z Number of Baths Ej Lot size______________________________________________________________ <br /> Wafter Supply: Public system M 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 INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest wellN!an�-----Distance from foundation-- erial..__ _ 'C_�____ nCYf __. <br /> [2; No. of compartments------------- -----------Capacity-----9QD----G---Size__ U_Liquid depth--------- 21--------_. <br /> Cesspool: Distance from nearest well._I?NK4-__Distance from foundation--------------------Lining material-------------------- ----------------- <br /> ❑ Size: Diameter--------------------------------------Depth---------------------------------------------------- <br /> Privy: Distance from nearest well----------------_----------_---------------------Distance from nearest building--------------------------------------- <br /> 13 <br /> __________________________-__-_ -___❑ Distance to nearest lot line________________________________________________ <br /> Seepage Pit: Distance to nearest well---- 7_QD_Q------Distance from foundation___- _____.Distance to nearest lot line___2 _+ <br /> Number of pits._..------ -_--------Lining material ConCret�Size: Diameter--------53...........Depth--------_1 8 1 <br /> Disposal Field: Distance from nearest well__31-WitDistance from foundation_____/_4-_-------Distance to nearest lot line__.r.C__:_____ <br /> ® Number of lines------------l------__ Length of each line_____________50#____ ___-Width of trench________2411-------------------- <br /> Type of filter material------- _�!....RkDepth of filter material_________121--_-_-- <br /> Remodeling and/or repairing (describe)---------Neti-- nj ta7_'xt1P__n------------------------------------------------------------------------------------ <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 o((f11 the San Joaquin Local Health District. /�1jY <br /> (Signed)._ D. ._.At.... ` i--- i ? �._.T19.1J_A-------R---------.__-----------♦----------W---------7-.--------s--------------(CXk a ffcV* Contractor) <br /> BY� --- -- - -------(Title)-------Estnatnr— ---------------------------- <br /> (PI pla , s owing size of lot, location of s em in relation to wells, buildings, etc., must be filed with this application). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY_________________________ /�' � 7-3� <br /> ----------- DATE <br /> REVIEWED BY-------------------------------------------------------- ----- ------------------------------------------ DATE-----------1- 2 . _ _7-s <br /> BUILDINGPERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE-------------------------------------------- <br /> Alterations and/or recommendations:---------------------------------------------------------------------------------------------------------.__------------------------------------------------- <br /> ------------------------------------------------------------------------------•----------­------------------------------------------------------------ --------------------------------------------------------------- <br /> --------------- <br /> ..... <br /> 01. <br /> ----•-•----•-••-------•-------------•---------------------•-•------------------------------------•------•---------------------------------------------- ---- --- -- - - ..----------------------------- <br /> PERMIT No.___,/6_Z__-----_ -------(Date) FINAL INSPECTION BY------------- ------- --------------- <br /> Date------------------------/?-- -_--- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street <br /> Stockton, California <br /> ES-9-2M 9-54 W-1639 <br />