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x { •%-� APPLICATION FOR SANITATION PERMIT . i 9 (Complete in Duplicate) y' plication 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-------------------342`7-E:__Weber-Ave; 9tockton------------------------------------------------------------------------- ----- Owner's Name-------------------------------------------------------hf 1--�9---- !*w-------------------------------------- ---------------- Phone-------N©A@---------= Address-------------------------------------------------------------------3121-74-Mem_--Lve-------------------------------------------------------------------------------------------------- Contractor's Name-----------------------------------------------D. _A---PARRTSH-&_SC�P�S----�----'-•--------------------------------- Phone--------9n9 ---------•-- i Installation will serve: Residence Ifl Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: Q. Number of bedrooms [ Number of baths [31 Lot size----60_tx7.I01------------------------I____________ i Water Supply: Public system [X Community system ❑ Private ❑ Character of soil to a depth of 3•-feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe EX H�rdpnn ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) f Septic Tank: Distance from nearest well---None___Distance from foundation--- ________--Material________0___0__ _-_______________. No. of compartments-------9-------- ___Ca acit �W ___Size___-566_ _2ft23.!!_.Liquid de th_--_52*______________ Cesspool: Distance from nearest well_________________Distance from foundation-------------------. Lining material---_---_____------------------------.NJ 0 Size: Diameter--------------------------------------Depth---------------------------------------------------- Privy: Distance from nearest well-------------------------------------------------D'astance from nearest building------------------------------------------ El Distance to nearest lot line------------------------------------------------ L—D-1 Seepage Pit: Distance to nearest well ____N3Q_______Distance from foundation_ 451________.Dis+ante to nearest lot line______81 A Number of pits_________I_________Lining material_____�`_+___Q_XUke: Diameter------- 3ft---------Depth_________-22t-------- Disposal Field: Distance from nearest well---19AO_---Distance from foundation-----151'______.Distance to nearest lot line-----$S. Number of lines_____7-_________________-_______Length of each line________4q______-______..Width of trench______241------------ -- Type of filter'material________- __$k__Depth of filter material--------18.!------ Remodeling and/or repairing (describe)_-------------_New installation -----------------------------------------------------------------------------•--- •-----------------------------------------------------------------------------•----------------------------------------------------- ------------------------------------------------------------------------------------ --------------------------------------------- - - ------------ ------------------------------------------------------------------------- --------------------------------------- hereby certify that I 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_Sr �Si�-------------------------------------------------------------------------------------- ---( Contractor) "H BY:------- D --------(Title)--- Etlli�to1` --------•-------------- -------------------------------------------- (Plot plans, sh i ';size of lot, location system in relation to wells, buildings, etc., must be filed with this application}. FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY----------------------------- - - _ _ DATE----------- _ �^ -- ------------- REVIEWED BY-------------------------------------------------------- �- -------------------------------------------------------- DATE--------- - 1W- BUILDINGPERMIT ISSUED----------------------------------------------------------------------------------------------------- DATE---------------------•---------------------------------- Alterations and/or recommendations---------------------------------------------------- -------•----------------------------------------------------...•----------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ -------------------------------------------------------------- -------------------------------------------•------------------ -- -----------------------------------------------------------------------------------------•----------------------------- -------------- --------------------------------------- �. ---- -------- PERMIT No.-' _ ISSUED____ ____-_3~___- -___----_____(Date) FINAL INSPECTION BY:------ -- - -- ----- ----------------- k --------------------��'-� / r --- /-A---- Date SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California ES-9-2M 9-50 W-1639