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APPLICATION FOR SANITATION PERMIT Permit No. .. 5 ___.. <br /> (Complete in Duplicate) <br /> Date Issued <br /> Applica*ion 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___�5-�____�� 1 Sunset Ave. Stockton <br /> -- -- -- -- • - - -- -- -- - <br /> Owner's Name---------------------------------------------------I & Lillie Speegle (Leaseholders) Phone---Ho b7148--------- <br /> ---------•--------------------•------ <br /> Address Same <br /> --------------- - --------------------------------- <br /> - _PARRISH IN C-.- H4 d96Q7 <br /> Contractor's Name-----+----------------- -- - ---------------------------------------------•---- Phone <br /> will serve: ,,Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other M Hestt <br /> Number of living units: _-_-1_ Number of bedrooms _5____ Number of baths __9_-. Lot size ____ -_X75-1------------------------ <br /> Water Supply: Public system ] Community system ❑ Private ❑ Depth to Water Table Yp__ ft. Plus <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam [] Clay ❑ Aclobelff Hardpan ❑ <br /> Previous Application Made: Yes E] No ❑ New Construction: Yes ElNo [:] Supplementary Drainage 1 <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: i <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) 1 <br /> Septic Tank: Distance from nearest well________________Distance from foundation-------------------.Material----------------------------_-__________..______- <br /> 1303.Sting No. of compartments------- ------------------Size--------------------------------Liquid depth--------------------------Capacity----------------------- <br /> Disposal Field: Distance from nearest well------------------Distance from foundation__--________._..___.Distance to nearest lot line_______-________ <br /> 1 <br /> E©isting Number of lines-----------------------------------Length of each line-----------------------------.Width of french------------------------------------ <br /> Type of filter material---------------------_---Depth of filter material-----------------------Total length___-_______________________----______..__ <br /> None ' <br /> Seepage Pit: * Distance to nearest jell______________________Distance from tiDistance to nearesti line_____10_____ <br /> 1 G op <br /> E®i�Sti Number of pits.-- ------------------Lining material-----------------___--- ize: Diameter-----------------------Deptn_.___._._.________------ <br /> Cessp4oTa Distance from nearest well-----------------Distance from foundation--------------------Lining material______________.___________-__________. <br /> ❑ Size: Diameter-------------------------------------Depth--------------------------------------------- --.Liquid Capacity----------------------------gals. <br /> Privy: Distance from nearest well-------------------------------------------------Distance from nearest building------------------------------------------ <br /> El ...Distance to nearest lot line---------------------- ---------------------------------------------------------------------------------------------------- ----------------- <br /> Remodelingand/or repairing (describe)---------- -----------------------------------------------------------•--.._..-------------------­ --------------------------------------------------- <br /> -------------------------------------------- <br /> ----------------------------------- -----------------••----•---••---------------------•---------- <br /> ----------------- ------------------------------ ---1-------------------------------------------------------------•------------------------------------------:-- -------------- --------------------- ------------- <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 /> PARRISH IN C ' ` O � Contractor)(Signed) ------------------ --- ---- <br /> cTle)_Estimator------------------------------------ <br /> By:--------------------------------------- --------------- �-- ---- '-.. -------------------•-- a <br /> (Plot plan, showing size of lot,rlocationn i systeri' in relation to wells,,, uildin19s, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY------- ----------- - ..... DA TE---------- <br /> -- <br /> REVIEWEDBY----------------------------------- DATE---------- --------------------- <br /> DATE----------------- �-­-_-_­- <br /> --.BUILDING PERMIT ISSUED--------------•-------- ----- - --------------- --------•-----------------------------------.._. +�-�--------------- <br /> Alterations and/or recommendations: ------- -------------------------------•---------------- -------------------------- ---------------- ---------- <br /> -------•------------------------------------------------------•------- -----------'- ------------- <br /> .---•----------•---- <br /> ---- ----------------- ---------•--------•---------•-------------------------------------•------•-•------------------�-------•------ <br /> ------------------------------------------------------ --•---------------------- -------------------------- <br /> --- -------- -- <br /> FINAL INSPECTION ----------------- Date---------------------- -------------- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street 132 Sycamore Street 014 North "C" Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> pt-4-9M ; Revised W-2100 '`"A <br />