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rSIN APPLICATION FOR SANITATION PERMIT Permit No. (Complete in Duplicate) 3 Date Issued .__/-/:,__%S___� 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. `JOS ADDRE; AND LOCATION____.. Linden___ on Linden Roach 2nd place this side of Malt Shop --------------------•----------------------------------- Owner's Name-------------------D,Lemastel' -. Phone--------------------_- - ---- ---------•---------------------------------------••---------------------------------------------------------------------•--- Address----------------------------Route 1__Box 88, Linden,California - --------------------------------------------------------•----....._ Parrish Inc 69607 Contractor's Name----------- - - - •------------------------------------------------------------------------------------------------------------------ Phone -HO----------- -------- ------- Installatidn will serve: Residence [�: Apartment House ❑ Commercial ❑ Trailer CourtM rel Other ❑ 01 Number of living units: _.------ Number of bedrooms _ 2..._ Number of baths __ 1__ Lot size ------ OO X O Water Supply: Public system 2 Community system ElPrivate E]Depth to Water Table _ 0_f ft. Character of soil to a depth of 3 feet: Sand [] Gravel ❑ Sandy Loam ❑ Clay Loam ® Clay ❑ Adobe ❑ Hardpan ❑ Previous Application Made: Yes ❑ No ® New Construction: Yes ❑ No [3 FHA/VA: Yes ❑ 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 ----- ----------- Distance from foundation ................... Material_...__.._._.........___-_.__....__.______.._... Fgi St iri pq P. ----Capacity------------- ------- g No. of compartmentswi uid de th___.________-- -----_ rf Disposal Field: Distance from nearest well--- 09_V-_P—_Distance from foundation ---- /_o_. .......... Distance to nearest lot line---- '4 - Number of lines ------- _---------- /._-_ Length of each line ---------- .__ ------------- Width of trench----a-Y...________.._._.... Type of filter material_-___�,_1&k_ ------- length_____________ -------- None ____ _ Seepage Pit: Distance to nearest well.. N©ne________Distance from foundation ---_30 r______.Djs�a ce to nearest lot I'EN }+O t Number of pits------ ------- -----Lining material-_---rOC�L----.-Size: Diameter--.------._.----------- Depth ------------- --------------- Cesspool: Distance from nearest well .................Distance from foundation -------------------- Lining material ------------------------------------- El ....___...___._._....._.------- -_❑ Size: Diameter --------------------- ----------- ---- Depth ---------------------------------------------------- Liquid Capacity ---------------------------- gals. �. Privy: Distance from nearest well --------------------------------------- _---- _---- Distance from nearest building --....________.__________---------------. ❑ Distance to nearest Jot line ------------------------------------ ---------- Remodeling -------- Remodeling and/or repairing (describe):-_ -------------------------------------------------------------------------------------------- -------------------------------- -•------- -------------• 1 ----------------------------------------------------------------•----------------------------------------------------------------------- -------------------------------------------------------------------- 6 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------- 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. Parr (Signed) ----------------•---------------i----sh------Inc------------------------------------ - - --------:-----------------------------------------------------------(Owner and/or Contractor) B ------------- Bill_ Wri_&ht•-------------------------------------- 5 ice[ Est y - -- - --------------------------------(Title)------ -------------------------------------------------------- (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY ------------------------ - ------ ----------------------------------------------------- DATE--------- �t REVIEWEDBY ------------------- -------------------------------- -- - -------------------------------------------- DATE BUILDINGPERMIT ISSUED------------------------------------------------------------------------------------------------- DATE Alteratioand/or recommendations--------------------------------------------------------------------------------------------------------------------------------- -------------------------- ---fir - -- ----------- - ---------/----------------- __.- _e - v------------------------------ F1NAL INSPECTION BY---------------- �f�`------------------------------------------- Date --------- ------- SAN -- - SAN JOAQUIN LOCAL HEALTH DISTRICT 130 Soufh American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy. California ES -9-2M Revises 1.57 FRCO.