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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. ------------ JOB ADDRESS AND LOCATION------ 22 -------- ---------- = / Phone_ 561------------------ Owner s Name------- ------------=---------------------- 3224 E. FrancA s Stt----Stockton---------------------------------------------------------------- ----------------------------------------- Address ------------ 8-8597 D. A. PARRISH & SONS� INC -------------------- Phone---------------------------------- Contractor's Name------•-- ---- - -----•-------------------------------------- Installation will serve: Residence'® Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: 1� Number of bedrooms 91 Number of baths] Lot size----3,�51I---1__" ----___-__- --------------------- Water Supply: Public system M Community system ❑ Private ❑ Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe [' Hardpan ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: J (No septic tank or cesspool permitted if public sewer is available within 200 feet.) '+ Septic Tank: Distance from nearest well ]D-P_"-___Distance from foundation___-- ---------Material----------------------------- - --------------. No. of compartments---•--��----------Capacity__ Q_'-�?'--_-Size---------------------•----------Liquid depth---�N "----------- t Cesspool: Distance from nearest well-----------------Distance from'foundation--------------------Lining material-----------------------------__--_- Size: Diameter--------------------------- -----Depth-------------------------------------------------- El Privy: Distance from nearest well--_I---------------------------------------------Distance from nearest building_-------__--___------------------------- ❑ Distance to nearest lot line------------------------------------------------- Seepage Pit: Distance.#o nearest well,_ e--------Distance.from found ation__-- ��~�_--_Dista D to nearest lot line_-9_-___--___-- �p l 'et - Number of its--------1------------Lining mat r = size: DiameterCr :L _-_---Depth---- --------------- ---- pc-LsI7 Disposal Field: Distance from nearest well_________________.Distance from foundation___-----_--__-_----Distance to nearest lot line.--------------_- ❑ Number of lines-----------------------------------Length of each line Width of trench ;. Type of filter material-------------------------Depth of filter material____---____--------_-_- Remodelin and/or repairing (describe ------------------------------------ -"--=�-a - ----- cin --------------------------2 l ee ss�oa_ 1----------- 0 _____ that %as been in use 20years._= Ido �reils in---�icsnit --------------------------- °rr p- Water ,Sery ce. . ----------------------------------•------------- - --- --------------•----------- -------------------------------------------------------------------------------=-------------------------------------------------------------------•--------- 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. @., P2 S & TiSs riC'==----- -- -------------------------------------------- �`d` Contractor) {Signed} = - - --- - - - 1. i t • Est na o B . 4 - - {Tit a --- --------- [Plot pl ns, wing size of lot, location of s em in�elatiort to wells, buildings, etc., must,be filed with this application). FOR DEPARTMENT USE ONLY I APPLICATION ACCEPTED BY------- -=------ - -------------------------------------------------------------- DATE------10 �`� `'------------------------ �-:�__�� REVIEWED BY----------------------------------- ------------------------------------------------------------------------ ----•---------------------- ----- - '------------------------------------------------------------------------ DATE------ ------------------------- BUILDING PERMIT ISSUED------------------------------- �; • -------- ---- -------------- DATE. r, Alterations and/or recommendations: 'S @ R=� -f °` -d "" �y {� • ---A-""_"".`"'--•^----','�'Y - - - •-•-- ti-�-f----- - 1-------7�J ---- ' --� -d- --ry'•�:�/Qr_ ---_�. 1 __ _"'�Q-v 4lS---_...---------- 100 ---' -- - ------ ------ -------1-7- - - '- - 'r t r , PERM IT No------- ISSUED_---,C-1---"--- - `' -(Date] FINAL INSPECTION BY:---- , - -"I -----=--------------------•----------.-.. .°. Date-------- ------------ ----------------- SAN JOAQUIN LOCAL HEALTH DISTRICT i� 43.0 South American Street 'Stockton, California - ES-9-21A 9-50 W-1639