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0 <br /> _ Per <br /> mitIN 3 `r ' <br /> APPLICATION FOR 5ANITATION PERMIT <br /> J J (Complete in Duplicate) Date Issued _ - --- <br /> Application is hereby made to the San Joaquin Locai 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. 1 y / S7_- (SO ( <br /> •1307 South Golden Gate, Stockton <br /> JOB ADDRESS AND LOCATION----�- - - - -- - -- ----------------------------------- <br /> .'' Paul AmadoT ----------------------- Phone----------------------------------- <br /> Owner's Name---------------------------------------- •------------------------------------------------------------------ <br /> iSame - ---------------------------------------------------- <br /> Addresso <br /> ----------••------------- •----------• -----S -- 9-9607 <br /> - ----------------------D� A� PARRISH & SONS� INC • -------------- Phone__.---•--------------------------•- ' <br /> Contractor's Name-------------------------•--_-.- ----- ----- <br /> ----------------------------------------------•-- <br /> Installation will serve: Residence Apartment House ❑ .Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> x - • <br /> Number of living units: _�- umber of bedrooms _2__ Number of baths __l__1__.__ Lot size _____60 _________120- ---------------- -------- --- <br /> Water Supply: Public system F-1Community system -ElPrivate [4 Depth to Water Table _ 0_ ft. <br /> l Character of soil to a depth of 3 fee+: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe)] Hardpan ❑ <br />? <br /> Pre pp <br /> Previous Application Made: Yes ❑ No XI New Construction: Yes ElNo E] Replacement <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> [No septic tank or cesspool permitted if public sewer is available within 200 feet) CC Bx'1Ck <br /> Septic Tank: Distance from nearest well_5r__0- _______Dis c}r�e fr9W foundation-99-2 <br /> omdation 20-------t 21v�aterial__ _ ____ ____ __ 800 Gale C <br /> ` 2 -- ---- S� x bb�g Liquid dept--- --------------------Capacity--- - ----- --------- <br /> No. of compartments---------- ---- - 3tr a- p - TI <br /> Disposal Field: Distance from nearest well___6Q_-___._Distance from foundation-,- --- to nearest lot line-- T <br /> Number of lines-------•--1___ i�--------------Length of each line--40't ofgfrench Ot4_------•------------ <br /> • �. Rk <br /> . Type of fil#er material__-- 2-----------------Depth of filter matenal______�`$--- -----Total len th____-------------------------------------- <br /> Seepage <br /> -__-_-• - ----------------------- <br /> Seepage Pit: Distance to nearest we-_ll_-loo-t--------Distance from foundation_�00_t__..__-.Dis <br /> tance to nearest lot line____5_ -_____ <br /> Number of pits_____ nng materia!_33 --------------Size: Diameter_____� e----------Depth----- Z t------------------ <br /> Lii <br /> ©� <br /> • <br /> Cesspool: Distance from nearest well----------.-------Distance from foundation___.----------------Lining material----------------------..____..-._____. <br /> ------Depth----------------------------------------------- Liquid Capacity-------------------- 9als. <br /> ❑ Size: Diameter------------- ------------ <br /> Privy: 61 <br /> Distance from nearest well______------------------------------------------Distance from nearest building__--__________------_------------.-- - <br /> ------------------------------------------- <br /> ❑ Distance to nearest lot.line-----------------------------------------------------------. :------•---- <br /> L Remodeling and/or repairing {describe):-------------------------------------------------------------------- •-------------------------------------- <br /> Remodeling <br /> ------------------------ -------- <br /> ------- <br /> --------------------------­-- <br /> -------- <br /> --------------------------•-----------------------------•---------••---------------------------- 'IV <br /> afion <br /> and <br /> ---------• --------- ----- -•--- = ------ ------ - --- ------- <br /> that <br /> wor <br /> ordinances,bState liawsh have <br /> olf the San Joaquin LocalkHeall+heD trici'n accordance with San Joaquin County <br /> A. PA RISH & SONS, INC - " _----- r Contractor) <br /> ---------------------------- <br /> Si ------------ <br /> (Signed) <br /> -----[Title)---------------------------------------------- <br /> liy'__" buildings, etc., can be placed on reverse side). <br /> (Plot plan, o ing size of lot, location of sys em in relation to wells, <br /> s FOR DEPARTMENT USE ONLY ° <br /> DATE-------------- <br /> APPLICATION ACCEPTED BY---- ------------------ - ---------------------------- <br /> '` �Y`--------- <br /> i REVII WI D BY D ADATE -T --------------- <br /> -----------------E---------------------------------------------------------------------- <br /> BUILDING PERMIT ISSUED--------------------------------------------------------------- <br /> ---------------------- - ----------------------------------- <br /> Alterations and/or recammendations:______________---------------------- - ---;------------------------------------------------------------------------------------------------- ------------- <br /> --------------------------------------------------------- <br /> ------------- ---------- --------------------------------------- <br /> -------------- -------- ----- <br /> --------------------- --------- <br /> ' -_________-________._- Date_____________�----- ------------------------------------------t. <br /> FINAL INSPECTION BY:______------ -- -- ----- - ----- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 300 West Oak Street 02 Sycamore Street 814 North "C" Street <br /> 130 South American Street Trac California <br /> Stockton, California Lodi, California Manteca, California y <br /> ES-9-21v1 8-51 Revised W-2100 <br />