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I � � 6� APPLICATION FOR SANITATION PERMIT ' (Complete in Duplicate) Application is hereby made to the San Joaquin Local Heaith District' for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. _ -----------------------•-------- -------------------------------------------- JOS ADDRESS AND LOCATION---------�5��_ _ �--�- -4- _��e -------- -------- -- -. _ Owner's Name------------------------------------------?_e_diDr1Co_.C-a1vo2i2------------ ----- ----------------------------------------- Phone------------XOVe------------ ------------------------------------------------------------- �+ Mary_-Ayenup-------------------------------------------------------------'------------- ------7-------------------- Contractor's Name !-- ' PARRISH.-& SOTdS,;- C---------` Phon9.'J(Q-------------------- Installation will serve: ResidenceXX Apartment House ❑ Commercial!❑ Traiier Court ❑ Motel ❑ Other ❑ Number of living units: [2 Number of bedrooms m Number of bathsl]f Lot size----------60_Moat------------------------------ Water -- --------------------Water Supply: Public system [I Community system ❑ PrivateX] ,% ' Character of soil to a depth of 3 feet-. Sand F1 Gravel ❑ Sandy Loam El Clay Loam ❑ Clay E] Adobe Hardpan E] TYPE OF INSTALLATION AND SPECIFICATIONS: / (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest 2 ell____4Q_1_____Distance from foundation__ 101-��n aterial __ Y'G� O - "'ar les No. of corrmpartments_________________ Capacity------8aQ �' Size --- ----- 6 ----Liquid depth----5Zt-u------------ Cesspool: Distance from nearest well_________________Distance from foundation------------------- materia____._____.___________- Size: Diameter---------------------------------------Depth------------------------------------7---- El ' ,I Distance from nearest building----------------------------------- ;Privy: Distance from nearest well_________________________ _ ❑ Distance to nearest lot elin ,Seepage PitDistance to nearest wel ______--Distance from foundation___---�___------.DEstance to nearest lot line___ _ __33_-=-__= `Depth_-- ----84-----X] Number of its__-_____a-____ ng materia4__ 0�-rC"' Diameter.=__,__ r ^" ________Distance-from foundation_______1� ____Distance to nearest lot line--'51--4 �— -"DisposaI-Fi61d: Disfartice from nearest well_ __- x Number of lines------------------x-- ----------Length of each line_-----301--------------- of trench-----_2 ----------------------- Type of filter material------1; __--RUDepth of filter material_____- ----- t Remodeling and/or repairing (describe):------ New---ine_tallat_ion__on---ai_a11 ---�oun�-,_of-------------------- ------------ r -------------------- - Y .lable JoaGe y Y ---- ----------- - ------------- ______ ` I hereby certify that I have prepared this application and that +he work will be done ;n accordance with San Joaquin County ordinances, State laws, and rules and' regulations of +he San Joaquin Local Health District. (Signed) D. SOt� ,__-INC.-------------------'--------------------- = '---------- �Contrac+Or( pY:----- ----------- ---- By -- - -- - - - ---------------------- -- ----- ---(Title) __ .Ii?& Qr'-------------------- (Plot plans, ing size of lot, iota+ion f syf+em in relation to wells, buildings, etc., must be filed with this application). FOR DEPARTMENT USE ONLY - DATE----------- /-------------------- APPLICATION ACCEPTED __ �-------- -�. - ----- DATE------------------------------------- ------------•-------- REVIEWEDBY----------------------------------------------------------------------------------------------------------------------- BUILDING PERMIT ISSUED-----------=----------- ---------------------------------------------------------- --------- ---- DATE----------- --------•----- ----------- --------------� Alterations and/or recommenda+ions------------------------------'--------- ------- ---------- ----------- -----------•--- --------------------------------------------------------------------- ------------------------------------------------ -------------------- ----- ------------ ------------------------------------------------------------iw---------------------s �- ------------- -------------------- PERMIT No.6__c�.------------ ISSUED------ --+ ----- ---J---�-------(Date FINAL INSPECTION BY:--------------- Date-------- ----------- ........ 2--c-- _ ------------- ` SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California ES-9-2M 9-50 W- 639