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APPLICATION FOR SANITATION PERMIT r (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 1 with County Ordinance No. 549. JOB ADDRESS AND LOCATION------- _ 7Ee main Street,* Stockton ealiPornia. IW, Owner's Name---------------F!--L-+-----.-XARC Dg-- ----------------------------------------- -------------------------------------------- Phone..... P_-_5B3_$------------- Address-------------------- 557---K+_ n--- treG_1_.+-;_..Akq w-------------------------------------------- --------------------------------------------- D. A. PARRISH & SONS, INC` 9-9617 Contractor's Name---------- --- Phone Installation will serve: Residence ❑ Apartment House ❑ Commercial g] Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ❑ Number of bedrooms ❑ Number of baths �D t94105-Acres---------------------------------------- Water Supply: Publics stem Communit system Private O� PP Y� Y ❑ I Y Y ❑ � Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Gay Loam ❑ Clay ❑ Adobe l] Hardpan ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) ]�O-E________ Materia�GQr3cree-Ci_r__.a-BridAi Septic Tank: Distance from nearest well_2QQ_1____Distance from foundation____ �� ,Y°3 O 5--- 6a -__Li quid de th____5_. _ ----_--_-. No. of compartments------'Z--------------- --Capacity--- ----- --------SizeA 3f.3t Sep G P Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material----------._______-_______-------____. ❑ Size: Diameter--------------------------------------Depth----------------------------------------------------- Privy: ------------------------------------------- ------Privy: Distance from nearest well-------------------------------------------------Distance from nearest building-----__________-_____-------_._________-. ❑ Distance to nearest lot line______----"____________________________________ Seepage Pit: Distance to nearest well----------------------Distance from foundation--------------------Distance to nearest lot line----------------- . ______• ❑ Number of pits----------------------Lining material-----------------------Size: Diameter-----------------------Depth______-_--___________________---- Disposal Field: Distance from nearest ieii,_ _E____Distance from foundation__1Q 1___-----__Distance to nearest lot line___9�____-- Len th of each line_,-7Z-----------------Width of trench-------2'�_--"--__------------ ] Number of lines___________ ___' g Type of filter mate riaL__ rip---�---Depth of filter material---------12--______ NeW installation for small pepper packing plant ..Remodeling and/or repairin (describe):-------- --- - --- ------------------------------------------------------------------------- - opera Cn a small crew_ seasonali *. -------- F --------------------------------------------------------------- ---------------------------------------------- ---- ---------------------------------------- --- ---------- - - -------------------------------------------------------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, Stat ws, and rules and' re ons of the San Joaquin Local Health District. t s Si ned A. Pa 11, r�Sons� J.nr+ --------(�r Contractor) -------------------------------------------------------------------------- Tale Estimator (Plot plan showing size of lot, location of s utero in relation to wells, buildings, etc., must be filed with this application). FOR DEPARTMENT USE ONLY DATE------------ ��/�� = _ APPLICATION ACCEPTED BY_________________----Gr1-�---� � REVIEWED BY -------------- ----------------- -------- --- -------------- ------- ------ -------------------------------- DATE---- ---------1---f----- ------------------------- BUILDINGPERMIT ISSUED------------------------ -- --------------------------------------------------------- DATE-------------------------------------------.----------------- Alterationsand/or recommendations:------------------------------------------------------ ------------------------------------------------------------------------------------------------------- --------------------------------"----------------------------------------------------- --------------------------------------------------------------- - -------------------- ------------------------------------ -------------------------------------------------------------- -- - I ---------------------------=-r---------------------------------------------------------------:------ ------------------------------------------------------------- -------------------------------------------------------------------------------------•---------------=-------- --------------------- ------- - 44 PERMIT No..:��.2`�---------- ISSUED------ -'/� —S-/----------(Date) FINAL INSPECTION BY:--- _ -- --- jIj----------------------------- ' ____ -R-l �" Date--•------- ------- - -------------------------------- SAN ------ -- -- -------------SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California ES-9-2M 9-50 W-1639