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f - APPLICATION FOR SANITATION PERMIT Permit No. �_�._!__.... (Complete in Duplicate) ll Date Issued Application is hereby ma e to the San Joaquin Loca! Health District for a permit to construct and install the work herein descrribed. This application is made in compliance with County Ordinance No. S49. JOB ADDRESS AND'LOCATIONJ____-_-2851___So. McKinley Avenue Stockton Carmen RuIZ----•--------------------- Phone - --6z Owner's Name •------------- --- -- - 4" -2---9----------------- Address-------------------------------------- •--` 2 851 So.. McKinley Avenue ----------•-------•----.------ . -----••-----•-----------------•--- ------ -----------------------...._..._--.. � --------t PARR TSH INC. - - . Contractor's Name------------------- -----------------------------------------------------------------------------------•---------------------------- Phone---•9-!-�6©7 Installation will serve: Residence ] Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: __. __'Number of bedrooms __2_ 'Hurn of baths ___l__ Lot size ___65_T___ 135' Water Supply: Publics stem y •Community system ❑ , F vate ie Dep+h to Water Table3 _?_ ft. Character of soil to a depth of 3 feet:' Sand ❑ Gravel,[]' Loam E] Clay Loam E] Clay ElAdobe � Hardpan E]1 Previous Application Made: Yes E] No ® New Const�ruu�F77-cy Yes ❑ No ❑ Supplementary drainage TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer.lis available within 200 feet.) ' Septic Tank: Distance from nearest well_________________Qi's-fa nce from founti daon_______-.__ Material __.______.____________- ExItting No. of-compartments----- -------------.. --Size---•-------------------•- Liquid depth----------- ------------ Capacity,---------------------- Disposal Field: Distance from nearest well--------- Distance from .foundationsn--r ...__.Distance to nearest_lot line_______________ Ext1 Number of linesi_..._•_-•_-- s{, Ljength of each{1 line---------------------- Width of trench -_---------.------------- Type of filter,'materia!__�._____________________Deph of filter.;material_��______ Total length_-_.____'` ,_______ _______________-. f '!' r --` 3 Seepage Pit: Distance to nearest wel.n-None{ Distan e from foundation--------------------Distance to nea4 lot,iine---5.'____..._ Number of pits-__,' + *' "Lining materiae__Br1Gk5ize:'6iameter----33»..._ p ' t ------Depth-,'-2-5 Cesspool: Ditance tom nearest well -__- -_.Qistance fromfbundation---- _.___.Linin materia! i ::-_- --_--_ ❑ P ..eSize::Diameter t3�a' �: � Dr h _ Y' 9 - ------ - Liquid'Capacit - als. t � i. Privy: t �'"`' Distance from nearest * s well______________ __________________`._____________Distance from nearest building-! ---------- ----------------------- El - - y s nearest lot line--------------- ----- -------------------•-------------------- ------------------------------------------- Distance to Weare Remodeling and/or repairing (descri a =•..�.------.1 ~ be) ------ --------- ---------------••----------- --------------- 7 ---------- ---=------ ----------- f •- --- ______________________________________________________________________________ I hereby certify that I have piepared-this'application and that the work will be'done in accordance with San Joaquin County ' ordinances, State laws, and rules and regulations of'fhe San Joaquin Local Health District. • (Signed)------------------ARRISH INC ------------------------------=------- --.--- ( 'r Contractor) By:------------------------------------,-�-= I'�-t , . . [Titled Estimator 1. (Plot plan, showing size of lof, bcation of sy ei1►-inelation fo�we sl buildings, etc., can be placed on reverse side): FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED B --------- -- -- ------------------ ----------- DATE- REVIEWED BY _ = ------------------------ --------------- ----- DATE----- �----- BUILDING PERMIT ISSUED------ -- ---------------------------------------------------------------------------------- DATE----------- Alterations and/or recommendations=------------- ----------------------------------------- ------------- -------•-----------------------------------------------•.._ ------------------- ------------------------•_----------------------------- =---------- --- ------------------------------------------------------ ----------------------------------- ----------------------------- I FINAL INSPECTION BY:: ---- ------ Date SAN JOAQUIN LOCAL HEALTH DISTRICT I 130 South American Street 300 West Oak Street 132 Sycamore Street 014 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California 1=S-9-2M 10-52 Revised W-2100