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Permit N . ---3-.b s• .. <br /> APPLICATION FOR <br /> SANITATION PERMIT <br /> ] 1 (Complete in Duplicate) Date Issued _y= - ------- <br /> Application <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. . 1.5- 7`^13 0 —(C) <br /> •1301 south Golden Gate, Stockton••••.---------- •--••------ ---------------------•--- ... <br /> JOBADDRESS AND LOCATION---.........--- -------•-•-•----------- ---------------------------------------------- <br /> 'Paul AmadoT -- -- ---------- ------ -------•--------- -- ---- Phone----- --------•------------•--•- <br /> Owner's Name--_-------•--_----.------------------- -- ----- --------- ..........._------- <br /> Same <br /> ---- <br /> }S - -- <br /> ---------------------------------*------------------- <br /> ---_--------.-_----••-----------------------------------------------------------------•------.-_- <br /> Address-----_-_---_--_ - <br /> D, A. PARRTSH &"-S- 0A15� INC • - --- - ---- --- ------.. Phone----- •---..._..._..---------......, ' <br /> Contractor's Name-------------------------------------------------------------------- ---------------------- -----------Trail <br /> Installation will serve: Residences Apartment House L] -Commercial 11Ter Court El Motel L] Other [:1 r <br /> Number of living units: A__kumber of bedrooms -2___- Number of baths .___..-_ Lot size _60...x­1---- <br /> Community system ❑ Private 9 Depth to Water Table _40- ft. <br /> Water Supply: Public system El <br />' Clay Loam Ll Clay 11 Adobe{] Hardpan ❑ <br /> Character of sail to a depth of 3 fest: Sand ❑ Gravel 171 Sandy Loam❑ <br />' Na laement <br /> Previous Application Made: Yes f3 No X) New Construction: Yes ❑ ❑ Re pf; <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if u clic sewer is available with 200�� ) CC BT9.Ck W <br /> Septic. Tank: Distance from nearest well 5_____________DAq <br /> a fr � Faun ation____......_-..-.-__-IV1ateria......_____-- $OC Gals p <br /> Z SiY. IB__....Liquid dept62_.- - --------------Capacity---- - ---- -- <br /> No. of eompartments.....___-. -----.....--• • ep <br /> 6d!__-..Distance from t`oundation._34 -------Distance to nearest lot I e__ .._._____ }� <br /> Disposal Field: Distance from nearest well Width of trench <br /> Number of lines_._____.-1••• _i' Length of each line__��_---_------------- 40 <br /> } <br /> 1$ .__.....Total len th... ...... ---- - ------- <br /> Typo of filter material__ - -...Rk-----Depth of filter material__-. _ 9 <br /> Seepage Pit: Distance lo nearest well. 100,._..•_-Distance f nm Distancefoundation_1d0_-t_...... # to nearest loft line.__..-____-____ <br /> l .._-... Sire: Diameter...._,W� --- Depth._.;_�� ......----------- <br /> IN <br /> Number of pits----................. Lining materia!_ - <br /> Cesspool: Distance from nearest well__-- Distance from foundation-_-.----- -.____---.Lining material......-------------------------------- <br /> 0"' <br /> Size: Diameter---- -- --­­------------ --------Depth -- -••-•---•------- Liquid Capacity ._.........._ g015. <br /> v <br /> Privy: Distance from nearest well---------.-------------------------••........_Distance from nearest building-- ------•.......---------------••••- A <br /> 1 ❑ - <br /> Distance-to nearest lot.line -------••••-• - <br /> L Remodeling and/or repairing (describe):____.- <br /> ---- -•- _ -----•----- ---- - <br /> ---------------------------•---••--••- <br /> - <br /> ------------------------ <br /> - <br /> -------------------_--.------- - ,_-...... - - - <br /> - ------------------ ---------------------------------------------------­--­------------------ -- <br /> I hereby certify that I have prepared fhis 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 /> RFs. PILY l H & so hS s INC. -_••--- r Contract <br /> -- -------- •..... <br /> --------••------------ ----------------------- <br /> ------• <br /> Estimator <br /> --•--•(Title)----- - - •-•---•-------- <br /> (Plot plan, o ing size of lot, location of sys em in relation to wells, buildings, etc., can be placed an reverse side). <br /> l FOR DEPARTMENT USE ONLY <br /> E - <br /> •--- <br /> APPLICATION AGCEPI FD B'f_._- <br /> .............. <br /> --- ------------ <br /> ------ DATE-------------- t ........... <br /> . DATE - --..........----- -- -----•••••••-••••------ <br /> t REVIEWED BY------_----------- - ---------------------- --------- ..... - ------ <br /> - DATE--- - -----••--•-- •• <br /> BUILDING PERMIT ISSUED --------------------- -----•------••----- ----••--•••--••----- ------••--- •------- <br /> • <br /> Al-terations and/or recornme>7 atians_____________ <br /> ------•--- <br /> ------------- <br /> -------------- <br /> --------------------- <br /> ---------- --------•-_.--. ----- <br /> r -----------••------ ------•--•-•--- <br /> ------ -• --- ---- <br /> ---------- <br /> -----••----------- <br /> ...- ..... _ <br /> i Date- ----- --- - <br /> FINAL INSPECTION BY_---- ----- •• --• ------ ---•- .------- ------- -- <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 340 West Oak Street 132 Sycamore Street 814 North "C" Street <br /> 130 South American Street Tracy, California <br /> Stockton, California <br /> Led;, California Manteca, California <br /> E5-9_2,M 8.51 Revised W-2100 <br />