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APPLICATION FOR SANITATION PERMIT Permit No­..A---5-161- <br /> (Complete in Duplicate) 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 made in compliance with County Ordinance No. 549. <br /> JOB ADDRESS AND LOCATION...._.__ 803 .........Stockton----------------------------------------- - <br /> Owner's <br /> S100-kton----------------------------------------- -Owner's Name------------------------------------ William---A--.-- T7 U-­Cke-r-------- - - ---- - - - Phone-&--.6-5--00 <br /> ­Address______________________-.._____-...____.__...._ _ .3308 Farmington Road-,-- Stockton <br /> ---------------------------------------------------------- <br /> ­­-------------------------- ------------------- ­ ­----------- <br /> Contractor's Name---------------------------------D._. A,.-.--PARRI.SH--.&---S-OPS-,�...INC.----------------:�--------­- ----------- <br /> ------- ------ --- -- -------- ------ <br /> Installation will serve: Residence R Apartment House 0 Commercial ❑ Trailer Court 0 Motel El Other El <br /> Number of living units: -1---- Number of bedrooms -Z- Number of baths Lot size -------I-A-cre.-..-------------------------- <br /> Water Supply: .Public system E] Community system C] PrivafaA Depth to Water Table -AP it. (30 <br /> Character of soil to a depth of.3 feet: Sand E] Gravel [] Sandy Loam El Clay Loam EJ Clay E] Adobe(Z Hardpan 0 <br /> Previous Application Made: Yes [] No4 New Construction: Yes PC No El <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 nearest well-.70........Distarice from f014nddt1,n 6 C,,C Brick <br /> 66 <br /> PQ No. of compartments--------2.--------- ..."X....3".-Liquid depth------5-2-7-----------..Capacity-------00--- <br /> Disposal Field: Distance from nearest well___80"-------Distance from foundation._.16"______._.Distance to nearest lot line-------10-2-. <br /> 24"Number of lines -------------------Length of each line----20?_.__.__._.__:_.Width of trench__-- - ------------------------- <br /> ---------------A, <br /> Type of filter material,,12" Rk ---------- <br /> ---Total length--------2-0f-------------------------- <br /> ---------------.--Depth of filter maferial--.19" <br /> Seepage-Pitt Distance to nearest well-­100-'­­Di,tance from founclation--AV.........Distance to nearest lot line-.P.... <br /> 20" <br /> Number of pits---"'-.1. ------ Blr:.I- *ize: Diameter-33--- ­.[�epjh---------------------------------- <br /> .. :__....Lining materiaICC_. <br /> �esspool:. Distance from nearest well-----------------Distance from foundafioh-------------------Lining material........................I <br /> ❑ Size: Diameter-------------------------------------Depth------------------ ------------ ------------------Liquid Capacity----------------------•----gals: <br /> Privy: Distance from nearest well-------------------------------------------------Distance from nearest building-------------------------------------- . I <br /> 171 Distance to nearest lot line--------'- ---------------I-----------------------------------------------I---­-------v.................................................I...... <br /> Remodeling and/or repairing (clescribe)-­­.-------------------------------------......................................................--------- -----------­----------------------------- <br /> ------------------------------------------------------------------------------------------------------------------------------------------------------------------7---------------------------------------- -------- ---------- <br /> -------------------------------------------------------------------------------------------------------------------------------------------------------------------•------ ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> I hereby certify that I 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 /> D. A. PARRISH & SONS, INC, 0 0 0 Y-Y.X xx <br /> (Signed)--------- -----------------------------­--------­---­-------------- ------------- ------------------------------ ......­­--------------------- ( kxx� Contractor) <br /> By:-----------------------------------------------------------------------------------------------------------------------------------(Title)----Estimator------------- --- <br /> -------- <br /> (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY - - - DATE <br /> -: -------------- <br /> ---------------------------------- <br /> REVIEWEDBY---------------------------------- �- ----------------------------- ­ -------- DATE ­ 5��............---------------------------- <br /> BUILDINGPERMIT ISSUED---------------------------------------------------- ---------------------------------------------- DATE------------- . --•....... ­---------------------- <br /> Alterations and/or recommendations:------------ ------------ ------------------------------------------------- ----------------------------------------------- ......................... <br /> ---------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------•-•---------------------- <br /> ------------•-------------- ------- <br /> -­------------------------ <br /> ---------------I-------------------­......... --------------­-1-------------------------------------------------------------------------------------------------- --------------------­--------- <br /> -------------------------------------------------- ........ ---­-­-------------- ---------------------------------------------------------------------------------------------------------------------- <br /> ----------------------­-------------------------------------------------------------------------------------------------- ------------­-- ­---------------------------------------------------------------------- <br /> FINAL INSPECTION BY:------- ------------------------------------- Date.......... - ----- ---"'?------- �------------------- <br /> --ff- -41 <br /> is SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> ES-9-2M 8-51 Revised W-2100 <br />