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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__--------------320$___E. Weber---Avenue------------____--4-_--_-------- ------------------------------------------------------- Owner's Name-------------------------------------------------lames...L-R---Bat_es---------------------------------- -------------......--- `.Phone--------)+-`-3900---------- Address------------------------------------------------------------1-0-815...X_Qrman.__Avenue------------------------------------------------------------------------------------------- Contractor's Name------•----------------------------------- PARRISH- &--SQN,S�---_INC- ---- Phone------9'-96Q,7-----------• Installation will serve: Residence W Apartment House ❑ Commercial E❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: [I Number of bedrooms E3L Number of baths [0 Lot size---------,r?Q_ ----X---140-!------------------------- Water Supply: Public systeml] Community system ❑ Private ❑ lv Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe❑ Hardpan ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: f (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest wel[_________________Distance from foundation-----------.---.___.Material------------------------------------------------- 171 ________------_____--------___._-______ ---_____❑ No. of compartments--------------------- ----Capacity-----------------------Size------------------------------Liquid depth-------------------------- Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material-------------------------------------- ❑ Size- Diameter-------------------------------------Depth--------------------------------------------------- Privy: Distance from nearest well_____________ ___________________________________Distance from nearest building Distance to nearest lot line_______________________________________________ Seepage Pit- Distance to nearest well-NPA-g!---------Distance from foundation__8_t-------------Distance to nearest lot line_____5 t xx Number of pits-------I---_--------Lining material---CC---Br1Ckze: Diameter----33-n--...........Depth---------2.2_t_______-__-------- -Disposal Field: Distance from nearest well---Nolle---Distance from foundation---8_1------------Distance to nearest lot line-------5t----- � Number of lines--------1_____________________Length of each line____________ _Qt---------Width of trench----------24!�--------_----_- Type of filter mate ria l_ f�___ OC�f.Depth of filter material_---_--- .8t�-----_ Remodeling and/or repairing (describe)-------------DrAlia---off--- xiatixxF,.__ eS5P001---_ -------. ------------ ------------------------------------------------------ --- - -----------------------•--•----------------------------------------------------------------------------------------------------------------------------------------=---------------------------------------------•-•--------- --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 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) �_ A,�•_- - _-R-_ H-&--- INC: --------.-------t- .- ------------,-------.____-- Owner and/or Contractor ------------------------------------- ------- - f / ) B • Title) SIlttS? (Plot plans, sho g 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 ------------ DATE------ f,,��'` ::; REVIEWEDBY------------------------------ n-------- ---- --- ------------------------------------------------------------------- DATE------` /2 ----,--------------------------- BUILDINGPERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE------------------------------------------------------------- Alterationsand/or recommendations:-----------------------------------------------------------------------•-------------------------------------------------------------------------------------- -------------------------------------------------------------•------------------------------------------------------------------------------------------------------------•----------------------------------------------_---- --------------------------------------------------------------•------------------------------------------------------------------------------------------------------------------------------------------- ------ ------------------ -------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------•------- ---------------- PERMIT No-----�_0_�--- ISSUED--- - -- --5.'--------------(Date) FINAL INSPECTION BY:-------V_61�-_--------_------_--------------- Date---------------- ------------------------------ SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California ES-9-2M 9-50 W=1639