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R APPLICATION FOR SANITATION PERMIT in Duplicate) (Complete P ) /0 8 - 110-2-1 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 leo. 549. r1r7Z "SWAIN OAKS" V> 0 JOB ADDRESS AND LOCATION---------------South' East corner of 07a-17 MT, & Mitchler Ave. Elmer Moore Phone 3--2639 Owner's Name ---------------------- - --- - - - - ------------------ -------------------------------- ----_3_ ------- *' Address-------------------------- -- -----------------41]___Hawthron-e Ave. Stock__ton, ' Cal. - --------- ------------------------------------------------------- D.A. P�.rrish & Soris, Inc. 8�-8597 Contractor's Name----------------------------------- ----Par-r-i-sh--- - -------------------------------------------------- -- Phone---- will serve: Residence EN Apartment House ❑ Commercial ❑ Trailer Court p Motel ❑ Other ❑ , Number of living units: �] Number of bedrooms 413Number of baths [j Lot size---------------150___X.--�5-..ft. n Water Supply: . Public system r5 Community system ❑ Private ❑ Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ . Clay Loam ❑ Clay ❑ `Adobe[N Hardpan 11 �4 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---X_'_----_---Distance-from 101 1-_______ aterialT", Bl.ks. © No. of compartments----------{:WO--------Capacity--200-----�- :----S4_zL&--3 _ P_Di_a•Liquid depth---5-----2 s a Cesspool: Distance-from nearest,well------------------Distance from foundetion--------------------- _ ----_---.Lining material_____ ------------------------_____-. ❑ Size: Diameter_ ----- y-------------------------Depth-_'_------------------I------------------------------ Privy: ---=---- _ ------------------------------ Privy: Distance from nearest'well__--------------------------- --_____Distance.from nearest building-------------------------------- ❑ Distance to nearest lot linea______________---------------------------------------------- w Seepage Pit: Distance to nearest well----140 e.--_-Distance from foundation---�_1--------- ante to nearest lot line 1D-.-- Number of pits---__One------__Lining material •---8 -Size: Diarneter---------------------.Depth-'_-----1'�-__-----__------_ Disposal Field:, Distance from nearest well---14-One__Distance from foundatig5-f-20-1-_--____.Distance to neares� 191 line-�I---_--_---- Number of lines-- One Length of each 5 �4 Width of trench__-------------------------------- Type of filter mate riall ��-_-x'oCk _Depth of filter material-12---------------- Remodeling and/or repairing (describe)---------------------------- - ----- ------------------------------------------------------------------------------------------------------------- ------------------------------------------------- ----- { ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 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. (Signed) D.A. Parrish & Sons ---------------------- AX Inc --------------------------- --- - (Owner and/or Contractor) tiles_-_Pa.rrish /�/� President BY: - {------- ----- (Title ------------ --------------- (Plot plans, showing size of lot, location of system in relation to wells, buildin s, etc., must be filed with this application). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-------- --------------------------------------- DATE------ `� REVIEWED BY- " DATE �� 4 -------- --------------------------------- BUILDINGPERMIT ISSUED---------------------------------------------------------------------- ------- ----------------------- DATE Alterations and/or recommendations:--------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- PERMIT No �J------------ ISSUED---- -u?-S---s�--------(Date) FINAL INSPECTION BY:--------------- .�)' � -- I' Date . �1 -J------------------------------------ SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California E5-9-2M 9-50 W-1639