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t. APPLICATION FOR SANITATION PERMIT (Complete in Duplicate) 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. JOB ADDRESS AND LOCATION--------------a-----_------KAM& -------------- __-els__NO.---Li.11i-an---Ave r---3tq*}on----------------- Owner's Name---------C-'-*----He---DESECAAR---------------------------------------------------------------------------------------------------- Phone------------------------- Address----------------`--=--:----4 '��--goi_!:Lillan Ave;_ Stockton t -- - -- - ------------------------------------------------------------------------------------- D• A.PARRISH & ►SONSs ZNC* -- Phone--9"'g611 -Contractor's Name---------- --------------------------------------- - ---------------------- e Installation will serve: Residence] Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: P� Number of bedrooms A Number of baths k Lot size__5D-1---R---13.08--------------------------------_ Water Supply: Public system ❑ Community system ❑ Private ' Character of soil to a depth of 3 feef:1Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe:91 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__-1-_-_---Distance from foundation_10 f Matr--- Coneriro--Bri __ C -- a----------c---k--- -- 60-____ xLiquid depth- 2--------------------xx No. of compartments-------- ---------- -- Ca acit -90-0--Ga - e� R� - .Cesspool: Distance from nearest well-----------------Distance from foundation-------------------Lining material-------------------------------------- 11 Size: Diameter------------------------- ------------Depth---------------------------------------------------- Privy: Distance from nearest well--------------------------------------------------Distance from nearest building----------------------------------------- El Distance to nearest lot line------------------------------------------------- g See a e Pit: Distance to nearest v�ell- Q Distance from foundation__---_----------DJ'� ce to nearest iot I,ne--_�---__51------ X] Number of pits__-------1-_______--Lining materia FisiQfl,gize: Diameter------J- s--------Depth____20--------------------- Disposal Field: Distance from near st well-----50-r----Distance from foundation___ �1_-.----_-Distance to nearest lot i 1______---- Number of lines--- --------- - ------Length of each line----------- _-------.Width of trench--_- 2 ---_._-_________- Type of filter material--_ - _ Flk----Depth of filter material-_1211 __-_________ � New installation ...Remodeling and/or repairing•(describe)----- ----------------- ----- t � t ----------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------- ------------------------------ ----------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------- I hereby certify that I have preps is application and that the work will be done in accordance with San Joaquin County ordinances, tate laws, and rules and' regulations of the San Joaquin Local Health District. ( ContracforSi (Signed) D• A: NL--- -- ------ Inc-*------ ----- *--------*------------ 0----------9--- B --- -- --%---- --1�--- ----------------------------------- fi $(Tce) 0V� (Plot pl s, showing size of lot,-location-of stem in relation to wells, buildings, etc., must be filed with this application). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY------------------- --- _j,r '"` ----- -------- -------- DATE--------- ----------------- REVIEWEDBY------------------------------------------------------------------------------------- ------------ --------------------------- DATE----------------------------------------------------------- BUI LDI NG PERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE------ ------------------------------------------------------ Alterationsand/or recommendations-------------------------------------- -------------------------------------------------------------------------------------------------------------------•---- ------------=-------------------------------------------------------------------------------------------------------------------------------------------------------------- ----------•.-------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ ---------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------- ----------------------------- '1 ) ---- -----------------------•------ PERMIT No.__-.Z-__( ----- ISSUED_---_'_3- - 3 ------- FINAL INSPECTION BY:-_-__VCJ__-- -- 2 Date---------------- - - -------------------------- ---- ------------------------ SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California ES-9-2M 9-50 W-1639