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FOR OFFICE USE: APPLICATIO SANITATION PERMIT I, Permit No. (Complete in Triplicate) -------------------------------------- P Date Issued �__- ._ .. This Permit Expires 1 Year From Date Issued Application is hereby made to the 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 and existing Rules and Regulations.- JOB egulations:JOB ADDRESS/LOCATION -----------H4Ze1tnA-1&--Vest'dura..... .vasA__Stockton,,--Gal if,-CENSUS TRACT -----------------•---•.--- Owner's Name -------------------- QPPe -BttC_-Storage__Wad' S2sE-----------------------•-------------------Phone ------------------------------ 2025 Went Haze-Icon Avea------------------- Stockton Cad,ifQrnia-------------- Contractor's --------------•----- Address - ---- -------=- ------ ------- �--------•- F • -------. City-# - ------------ - -----s--•----- Contractor sName ._____"__-.�".A,."_QaTxish_"8c--�ons�--�.nc*---------------= _. icense # ------1Q-0511----- Phone ----466960'I---------- f Installation will serve: Residence F] Apartment House❑ Commercial [:]Trailer Court ';❑ Warehouse Motel ❑_Other --------------------------------------- Number of living units------------- Number of bedrooms------------I-Garbage Grinder --------- -- Lot Size --_--___"""---_-_-"---------_------------•- Water Supply: Public System and name ----------Calif ornia.Yd.ted'--Se vice------------------------------------------------Private ❑ Character of soil to a depth of 3 feet: Sand'] Silt❑ Clay ❑ Peat❑ Sandy Loam 19 Clay Loam ❑ Hardpan-E] Adobe El Fill Material ------------ If yes,type "-_----""------------------- (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side.) O NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) PACKAGE TREATMENT [ I SEPTIC TANK�[[] Size-----VX12-----------------------------•-- Liquid Depth .----5211-_.------.----- [^ Capacity --090__Wr Type precast---- Material_-- Gonerete No. Compartments Distance to nearest: Well -----XQDe"--------------------Foundation -1501------------- Prop. Line ---5fl4----_-------- ------- Length of each line----bT------------------ Total Length --__200r LEACHING LINE [ ] No. of Lines _ "'"""""""""""•`--- ---- ----------- 11 'D' Box Con.— Type Filter Material1*'t__rock_-_Depth Filter Material ---___- � -------------------------•- 160'--------- Property Line --- 01---•---• ------ Distance-ta nearest: Well*=__ __1�9iTe_"""___ Foundation ____ -- _-- p tY SEEPAGE PIT Depth --- Diameter ---------------- Number ---------------------------- Rock Filled Yes ❑ No WaterTable Depth ------------------------------------------------Rock Size -------------------------------- Distance to nearest. Well•----_--._.:=-_-- ----------------...Foundation -------------------- Prop. Line __..-------------. --- REPAIR/ADDITION(Prev. Sanitation Permit# --------.----------------------------------- Date ----------------------------------) I tr Septic Tank (Specify Requirements) ---------------------------- ----------------------------------------------------- Disposal Field (Specify Requirements) ------------------------------------------ - - -------------------------- - ------------------- 11 -------------------------------------------------------------- ---------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------- ------ ------ ---------- ------------------------------------------------------------------------------------- (Draw existing and required addition on reverse side) I 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. Home owner or licen- sed agents signature certifies the following: ' "I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in such manner as to become subject to Workman's Compensation laws of California." Signed ....--. D-•-A'--Parrish & sons ---_ -c-.------- Owner Title ---- -------------------------P-r-esid-e-nt - ---------------------- - - ------ BY (I other than owner) /ONLY FOR DEPARTMENT USE �I - � -- - - APPLICATION ACCEPTED BY -- - --- -- ---- - DATE _. a BUILDING PERMIT ISSUED ---------------------- ---------- ----DATE ------------- ----------------------------- ADDITIONAL COMMENTS ---------------- � -- --------------- vvar �lLl�� CLb- 67� cep-=- ICYI ---5--- �'� '� �'�' - [ n--------- o--------------- __ ` �— 1 �s55L3r --_�r+ ?- ------ --------------�'l l -- T`r' Ft '`-. h�`N" 5 iE2Crdrf- Prsz elk5cvrl5 ` rs,f� + ' _�4�rr --- -- - t �Y �� Final Inspection by: �--r-- Da e SAN JOAQUIN LOCAL HEALTH DISTRICT E. H. 9 1-'68 Rev. 5M.