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. _ Ilzy- 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. N Rt. 4 Box 51b, Stockton,' Calif+ Uzi WaY- 99 South --- ---------------------------------------------------------------- ------- JOB ADDRESS AND LOCATION.- u -------------------------------------------------- 1�50HH �1 �'ri00k8 Phone ------------------ Owner's Name--------------------------- & ------------------------------------------------- -RBow---516#----Stock_ton----------------------------------------------------------------------------------------------------- Contractor's Name------P-`----A--- PARRT_a ---&-_ &--80N5 -- C-`.......`----- * ---- . ------------- --- - - ----------- Phone__-�'"----��-�------------•---- Installation will serve: Residence ❑ Apartment House [J. Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ 12 _cre s ______. Number of living units. '0] Number of bedrooms 13 Number of baths [3 Lot size__________-A_____"__----i_i----------------------- Water Supply: Public system ❑ Community system ❑ Private IN .' Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Gay Loam ❑ Clay ❑ Adobe E�: Hardpan ❑ TYPE OF INSTALLATION AND SPECIFICATIONS— (No septic tank or cesspool permitted if public sewer is available within 200 feet.] � - Concrete Circ-Br3.ck Septic Tank: Distance from nearest well___12_5-1---Distance from foundation oun anon____!-Q-�_rC.Material_____ _ _ _ _ _ _ _________�`_________-__- No. of compartments------- Capacity--- -0 Gal-z --- Liquid depth ` Cess ool: Distance from nearest well________________Distance from foundation---------------------Lining material-_____---________--____________--___. P i ❑ ---------- Size: Diameter------------------- ------------._---pePt ---------------------------:=--�-�-------- Privy: Distance from nearest well-----------------------------------------________Distance from nearest building____------------------------------------ w ❑ Distance to nearest lot line----------------------------------------------- .t i;�1� i Seepage Pit: Distance to nearest well-____24........Distance from foundation---20_________.Uistane to nearest lot Isne0 -'- Lining materia CiOnCX'Pe: Diameter---------.?�- ------.Depth------- ------------------ Number of pits_____1_--__ - x'C—Bx'1 C . �`�i Distance to nearest lot line-- 3S ine__ Disposal Field: Distance from nearest well----7-20-1--.Distance from foundation____ Len th of each line-----120-1--------------Width of trench---------2411------------------- Number of lines__--_____ -___-__i-t g Type of filter material-____1P______________Depth of filter material-------32��-------- 1 B�R to . . 11 dt o n---f ti�'---3--.unit _ agar�m�tz�'-------------------------------- Remodeling and/or repairing (describe):_______-__--g`v-_ SSG- __--_ -------��n---apt-�--------------------------- - -- ------------------------ ------------•------------- ------------------------------------------------------------------ --------------------------------------- - - - ----------------------- ------- = ---- --------- - - ---- ------------- ------------------------------------------------------ -- - - I 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. (Signe D� A Parris h & Sons---------------------------------------------------Ince -'------------------ ------------------------------------------ ( )Wa`09jN Contractor) By: - ------------ -- -- ----------- --- Title 1t] a.tor : : -------------------------------------- (Plot plans, showing size of lot, location of system in relation to wells, buildings, etc., must be filed with this application). FOR DEPARTMENT USE ONLY ' ------------------ DATE-------------� - ---`-�----------------------- APPLICATION ACCEPTED BY________ _____ v_�' - - --------- - DATE------------------!-"------------------- REVIEWED BY------------------------------- --- DATE--------------- ------------ --------------- ------------- BUILDING PERMIT ISSUED----------------------------------------------------------------------------------- --- ------------ Alterations and/or recommendations:------------------------------------------------------------------------------------------__""' ------------------------------------------------------------ 6� (Date) FINAL INSPECTION 'BY:.-- -qm - PERMIT No._�-Z_�--------- ISSUED----- - - --`---------' ---- Date------------------------ ----------------------` -3' ------------ SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California c ES-9-2M 9-50 W=1639 /