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A, APPLICATION FOR SANITATION PERMIT Permit No. 7.-_`_k. ___: ,fj (Complete in Duplicate} a 9 Date Issued ----____-- 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----___------150 5oe Windsor Avenue - ---- -- -------------------------- ----------------------------------------------------------------------------------------------- Owner's Name--------------------------------- - - Bernardino &IDOS ---------=---------------------- Phone----3 �---------------------•--- Address____________________________ 150 So, Windsor Avenue R •---------------------------------------------------------------------------------------------------------------------------------------------------- Contractor's Name--------------------------------------D e---A.___PARR1_SH & SONS, INC . e 9-9607 _ -•---•--- ----- Installation will serve: Residence$& Apartment House El Commercial E] Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ______-_ Number of bedrooms 3______ Number of baths ___1__ Lot size ------- 75_ X12t ________________________________ Water Supply: Public system [X Community system ❑ Private E] Depth to Water Table __4-0____ ft. ' Character of soil to a depth of 3 feet: Sand F] Gravel E] Sandy Loam E] Clay Loam E] Clay ❑ Adobe M Hardpan ❑ Previous Application Made: Yes ❑ No [N New Construction: Yes [X No ❑ 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-NoneDistance from fou dation_____1-Q_i_____-.Material_____CC Brick No, of compartments______ __2 _____- _Size_ 6nX�6n_��.-n Liquid depthCa aci -- t'r& q pP tY ---------- Disposal Field: Distance from nearest well'- e__-_Distance from faundatip�5 t ------------Distance to nearest Wine [Xs Number of lines___________________- Length of each line------_-(__-___ Width of trench_ ________._. 1�n R-k 1$11------ Type of filter material---------- -------------Depth of filter material----------------------- length------------------------------------------ Type 71 Seepage Pit: Distance to nearest well __ _ .______Olsten a fr m foundation-----g_�._---- Mance to nearest I t lin _____t__._._.____ Number of pits---------- --Lining materiae--�2' ------ e: Diameter-3_�----------------Depth- -_��---------••_-- Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material-------_-------------------- .._______. ❑ Size: Diameter------------------------------- ------Depth----------------------------------------------------Liquid Capacity----------------------------gals. y Privy: Distance from nearest well----------------------_--------------------------Distance from nearest building------------------------------------------ 171 ____________.______--.-_____________ __.❑ Distance to nearest lot line---------- -------------------•--------------------------------- .. Remodeling and/or repairing (describe)_______________________ ---------------------- - ------------------ ------------------------------------------- --------------------------------------------------------------------------------------------------------------------- I hereby cer ify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, St a laws, and rules and regulations of the San Joaquin .Local Health District. A. P R H & NS, INC. ty� (Signed) ; - (�' � r Contractor} Estimator By: '?... (Title)- 5 ----- ---- ------ ---- ---- - (Piot plan, s ar�iing size of lot, location of sys m inI relation to wells, buildings, etc., can be placed on reverse side}. FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-- DATE- REVIEWED BY '"` `� ---------------------------------------- DATE --------------------------- BUILDING PERMIT-ISSUED---------------------- - -------------- -------------------------------------------------------- DATE---------- Alterations and/or recommendations: #Ts��--------- - ------------------- ------------------------------------- -- -=------- ------------------------------------------------------------------------------------------------------ ----------------------------------- ---------------------------------------------------------------- ------- -------------------------------------------------------------------------------------------------------------------- {f I ----------------------------------------------- •------- --------------------------------------------------- -----------------------•---------------------------------- ----------------------------------------------------- - v FINAL INSPECTION BY----- -------- --------------- Date------ -- -' _---------------------------------------- SAN ----------------------------------SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2M 8-51 Revised W-2100 J}? - r