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APPLICATION FOR SANITATION PERMIT (Complete in Duplica+e) Applicati6 is hereby made to th� e 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--_-VSLLEY__-FRUT -__DSTRBUTC}RS,.--Victor Road - ----------•-----------�----V c t o r__Cal i�.-----• Owner's Name------Va Ley_Fruit--_Di :�ributors -- -- - ---- -------- -------- - ------- -- Phone-Lodi.------ - - ------------------------------- Address__-----•---©.--B-ox--Dx_.. c�or• .---On---victor--Road ------------------------------------------------------------------------------ -------------- Contractor's Name-------�-'----A-`----PARRI_►�H &---'�-�I�TS`-� --Z�-C'------- - - ------------------------- - ------------- Phone--- 878597 - Installation will serve: Residence ❑ Apartment House ❑ Commercial EX Trailer Court,[] . Motel ❑ Other ❑ Number of living units: ❑ Number of bedrooms ❑ Number of, baths ElLot size------- Water Supply: Public system ❑ Community system ❑ Private Character of soil to a depth of 3 feet: Sand EX Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay❑ Adobe❑ Hardpan 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--------------------Material___------_No. of compartments--------------- Capacity --__-----____----__ -------------------- -------------------Sze--------------------------------Liquid depth-------------------------- C%spoof: Distance from nearest well-----------------Distance.from foundation--------------------Lining material_---_-___-----_-------- ❑ Size: Diameter-------------------------------------- Depth--------•--------- ---------- ---------- - - Privy: Distance from.nearest well------------------ ------------------- --------Distance from nearest buildin ❑ Distance to nearest lot line 9 Seepage ----------------------- Pit: D-istance to nearest well------ from -foundation----9_r--____----Distance to nearest lot line_-F_.__----__- h Number of pits---------___----------Lining material � �n ize: Diameter aemei-rcP3RS --- ---..Depth-------- ------- ---- Disposal Field: Distance from nearest well---------------- .Distance from foundation--------------------Distance to nearest lot line___-_-__----._--- ❑ Number of lines-----------------------------------Length of each line------------------------------ Width of trench Type of filter material-------------------------Depth of filter material-_-_---- ______- Remodeling and/or repairing describe):_-_-_---Add t�on ._ drag nage f�pr�__present seep- -------------- carry mater cr ed b mct3.ri ice 1;18 -------------- sh . hereby certify that 1 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-___A.-PARRI SH & SONSINC. BY: _ -- ----- - --------------------- , -------------------------------------------------------- -- -- ----- Tale Esti mato r. . (Plot plans, showing size of lot, location of system in relation to wells, buildings, etc., must be filed with this application). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-----------------ZP� 0 . REVIEWED BY ------------------- DATE � '' I-------------------------------------- ---------------------- �-------------------------------- BUILDING PERMIT ISSUED------------------------ ----------------------- ---- - - ----•------ -------------------------- -------- DATE-- = Alterations and/or recommendations--------------------__-___- ----------------------------------------------------------- - t - ---- f ---- PERMIT No.------ ------------ ISSUED-- -- -a------(Date) FINAL INSPECTION BY----------- -------- - -- ------------ Date__!-�- - SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street ES-9-2M 9-50 W4639 Stockton, California I