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FOR OFFICE USE: -- <br /> ------------- -------- -------------------- ------------- 19y� <br /> ----------------------------- -------------------- APPLICATION FOR SANITATION PERMIT Permit No. .. ._.._._....... ... <br /> (Complete in Duplicate) <br /> This Permit Expires 1 Year From Date Issued Date Issued <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is�ade in jompliance with County Ordinance No. 549. <br /> A Stokle Van C s Canners Linden Rd. east of Linden on. North Side <br /> OB DDRESS AND LOCATION----- -------------�------------ •�------------------------------------------- - -- ------------------------------------------- ------------------- <br /> Owner's Name s ZoleZz --•------------- --------- Phone----••----_93i7 QZ9i------ <br /> Rt, 1 Box 161 Linden, California <br /> Address------------------- -•-------------------•------------------------------------------------------------------------------------------------------------------------------- <br /> Contractor's Name.-- D•A•...Parrish & Sons Inc. Ib6_g( <br /> ----- --•----------------------------------------------------------•------•-------------------•----. Phone...... p� <br /> -•- - • 0 <br /> Installation will serve: Residence ❑ Apartment House ❑ Commercial ba Trailer Court ❑ Motel ❑ Other ❑ f <br /> Number of living units: -------- Number of bedrooms -------- Number of baths 2-.- Lot size .-..-ACeragQ--------------------- <br /> Water Supply: Public system ❑ Community system ❑ Private ® Depth to Wafer Table ..6Qtft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam 11 Clay ❑ Adobe ❑ Hardpan p ; <br /> Previous Application Made: (if,yes,date--------------------) No E3 New Construction: Yes ❑ No ❑ FHA/VA: Yes ❑ No ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearesffwell'------150-11--Distance from foundation--------1Q!_....Material__...---Canexe-te--------------------- <br /> 2F No. of compartments-----Z------------ --Size------)4X559-------------Liquid depth------5411-------------Capacity--------800-------- <br /> Disposal Field: Distance from nearest well... ____Distance from foundation---------2Qf----Distance to nearest lot line-...*�... <br /> 13 Number of lines-------1-------------------------Length of each line------301----------------.Width of trench-'---24!t---------___T_ � <br /> Type of filter material----51-R-------------Depth of filter material-...-------0#----.Total length---------------3 ....._`.." ----------- <br /> „r,.' <br /> Seepage Pit: Distance to nearest well-_,__4$0_t_____-__Distance from foundation_..- 20.-- Distance to nearest lot <br /> IN Number of pits----------- ------Lining material-------S/R---------Size: Diamet&'71_--33'1-------. Depth- --------.a5-t---------------- <br /> Y � <br /> Cesspool: Distance from nearest well-----------------Distance from foundation----------------....Lining material-------------------.:.___------..---- <br /> ❑ Size: Diameter---- - -------------------------------Depth------------------- t ----------------------------Liquid Capacity----------------------------gals. <br /> Privy: Distance from nearest well-------------------------------------------------Distance from nearest building--------------------------------------- 1 <br /> 1 <br /> ❑ Distance to nearest lot line '-`- ---------------------------------- --------- -------------------------------------- <br /> �` a <br /> t . <br /> Remodeling and/or repairing (describe =— —__ = :_:_.= _ = _._.-•- ----------------••---------- - - <br /> • <br /> ---------------------------- -----------------------------• , <br /> ------------------------------------ ----------------------------------- <br /> ------------------------------------------------•---------------------------------------------------------------------------------•----- ----------------------------------------------------------------------- <br /> I hereby certify that 1 have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> Si ned D.A. P Trish &- S TriC -----------------_---_---(Owner and/or Contractor) <br /> BY:----- ----------------------------- -------------(Title)----------..Estimator <br /> t, <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> ,1 <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY- ------------ ----- ----� z= --�------------------------ DATE----- - �/3/!, <br /> REVIEWEDBY----------------------------------------- ----- ------------------- -------------------------------------------------- DATE----- -------------- <br /> BUILDINGPERMIT ISSUED------------- ----------------------------------- --------------------------------------------------- DATE-------------------- ------- <br /> ------ <br /> Alterations and/or recomme dations:__-___.... -_- s• -.- — <br /> ------------------'� -.7 l `-` <br /> ---•----------------------------------------------------------------- -- ------------------------------------------------------------------------------------------------------------ ----------- -------- ----------------- <br /> --------------­--------------------- ------------------------------------------ ------------------------------------------------------------------ ----------------------------------------------------------------- <br /> FINAL INSPECTION BY:. <br /> l/L- Date-------- <br /> --•------ - - ----------- - ---------------- <br /> 1 SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 91h Street <br /> r <br /> Stockton,California Lodi,California Manteca, California Tracy, California <br /> 5 F.P.CO. <br /> i <br />