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4�� <br /> APPLICATION FOP SANITATION PERMIT Permit Na. <br /> li (Complete in Duplicate) �1flS <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............1:331 Hamer Street- ..................................................... <br /> HarrCam b@�. ---•-----••........................•---••--•--.................-••---. Phone---------••-••-------•----------.--- <br /> Owner's Name----•-----..._...................�...__.......�-.._--•--..,......------_. <br /> Address---------------------------------.aw...�;a..ab.Q.7A.........------------........................-----------......._........----....---..........---------•-----•..........,•....----.......... <br /> Contractor's Name______________AA,-.-Parrish Sons--Inc...-••-.:_,_------ ..._..........._._..... Phone HQ._-6--7��1._..-- <br /> Installation will serve: Residence a Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: ....3... Number of bedrooms_ ... Number of baths A._- Lot size __...U.61... .Wt <br /> Water Supply: Public system ❑ Community system ❑ Private I$ Depth to Water Table ..50. ft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel-[] Sandy Loam ❑ Clay Loam ❑ Clay❑ Adobe KI Hardpan❑ , <br /> Previous Application Made: Yes ❑ No X1 New Construction: Yes ❑ No EX <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 well.................Distance from foundation.........-....-...Material--..---.-•-•.----._-_-------------•--.---_------. <br /> EasingNo. of compartments..........................Size---.--..-_--_-____------- --__Liquid depth....__.._..-.------__----Capacity._._--_ .------- <br /> Disposal Field: Distance from nearest well.......5C-t..Distance from foundation....2C-r•.......Distance to nearest lot line...10,...... <br /> (7� Number of lines._.__......Qne........--------Length of each ----- ..Width of trench......21+_.................... <br /> n <br /> Type of filter material-.S.,-__•ROCS-.Depth of filter material-___l _____________Total length___..._. fl__........................ <br /> Seepage Pit: Distance to nearest well...$C_ ...........Distance,from foundation.._..._5Ot___.Distance to nearest lot line---1Q.1...... <br /> ® Number of pits.....one........Lining material.rock-•-...__.Size: Diameter.........1W......Depth..........25................ <br /> Cesspool: Distance from nearest well.................Distance from foundation................_...Lining material.------------------------------------ <br /> 11 Size: Diameter......................................Depth-•----•---........:_........------..................Liquid Capacity............................gals. <br /> Privy: Distance from nearest well........................_.......................Distance from nearest building.......................................... <br /> ❑ Distance to nearest lot tine.......................................................................-•.................................................................... <br /> Remodelingand/or repairing Idescribe):....................................................................-------•--------...........------•------------•--.....---_...._..----•----...._... <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 /> DAPar.rish & Sons Inc <br /> {Owner and/or Contractor){Signed •----- ----•---------- ......................................................... <br /> By:. -----•-------------•-----------------------------•--•--...(Title)......ESTt....•----•--...---------- -- <br /> .• .... . <br /> ... <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc, can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY------ _ .....•.............-.......... DATE_- •\-----------•-------•----------------------------- <br /> REVIEWEDBY...........................------ .....•••••...........:.... DATE.-- •- .............-............................. <br /> BUILDING <br /> �P,E�R.rM <br /> IT ISSUED---------t-.-.-..----.-..-.---- --- �....._----•-•----..._.......... <br /> .................................. DATE <br /> --�--•----• DATE.... ..••. - <br /> --------•---•--.-.-------------:_--.: <br /> Alterations or recommendations:...................... ........._._.....---.....-----...._....---•-----.......------•-----. .......---- <br /> .. .-- ------.--•....................................................... <br /> ---------------- <br /> ..... .... ................... ... ... :... ......•-•--..... <br /> .. -•--•----•--•--------------•........... ----•- . ......... -------------------------------------- <br /> r . <br /> ...........................................•-•-----........-••--..................... ............................. .............. <br /> .................. t..� <br /> FINAL INSPECTION BY:__e <br /> ... Date•.__.-S.sa... `'� .......__._.._.... <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C"Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> ES-9-2M Revised W-2100 <br />