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-4Y--14_ APPLICATION FOR SANITATION PERMIT (Complete in Duplicate) i 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. /e d 1 r� JOB ADDRESS AND LOCATION _._�_8#(f Marshall Avenue-,----;oto_ckton-----------------------------------------`�----__...__---------- Stoc?�tnn Bc�x Coe-.pan.y Phone1----------- Owners Name - -------------------------------------------------- Address--------------------- 800 l;�xa�'shal.3. Avenue ---- 0 - ---------1 ---n Ds A. PARRISH & 50144 IT3C. 8-8597 Contractor's Name ----------- '--- Phone Installation will serve: Residence ❑ Apartment House ❑ Commercial Gg Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ❑ Number of bedrooms ❑ Number of baths ❑ Lot size ��'� -��= `-'--'-------------•-- Water Supply: Public system IX Community system El Private [I1 Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe g 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_________________Distance from foundation--------------------Material------------------------------------------------ - ❑ No. of compartments--------------------------Capacity-----------------------Size.---------------•---------------Liquid depth I 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------------------------------------------------ 4 est we Seepage Pit: Distance to .nearll_UY'�-_-_____Distance from foundatio � n____-- _ i_-_-__ anc a to nearest lot AAlii e__-___- _-. (q Number of pits---`---- ------------Lining material-----------------------Size: Diameter- �---- -----.Depth-,t--b_-___-_____-_---------- Disposal Field: Distance from nearest well-------------------Distance from foundation--------------------Distance to nearest lot line____._-_____-_--_ ❑ .k 'Number of lines'---------------------------------Length of each line-----------------------------Width of trench---------------------------------- Type of filter material-------------------------Depth of filter material----------------------- Remodeling _-_-_-___- .-_____-_Remodeling and/or,repairing (describe) ------ `J----- 7 1 ` -------- ----------------•--------------------------------------•--------- ,y f, -------------•----------•------- I-------------- - ---------- ---• -------------------------------------------------------------------------------------------------------------------------------------------awit ------ --oa hereby certify'-tha+-I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State law rules and regulations of the San Joaquin Local Health District. t r i (Signed)._ _ l+ �r �---�'---- Contractor By: --- ------------------------------------------------------------------------------ Title �-- ------------------------- (Plot plans, sh ing size of lot, locati of system in relation to wells, buildings, etc., must be filed with this application). FOR DEPARTMENT USE ONLY APPLICATIONACCEPTED BY-------------- ------- - ------------------------------------- -- DATE---------- -e—,,: .REVIEWED BY-------------------- -------------- --------------- ------------------------------------------------ DATE------------------------------------- BUILDINGPERMIT ISSUED--------------------------------------------------------------------------------------- - DATE----------------------------------------------------- ----- Alterations and/or recommendations---------------------- -----------•----------- -----------------_------------------------------------------------------------------_ { •-------------------------------------------------- ----•-------------------------- PERMIT No.__-,�'_0-.--------- ISSUED__I--_00_-_51--------------------(Date) FINAL INSPECTION BY.......... 14--------------------------------- % --- Date SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California ES-9-2M 9.50 W=1639