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APPLICATION FOR SANITATION PERMIT (Complete in Duplicate) Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. s This application is made in compliance with County Ordinance No. S49. ; JOB ADDRESS AND LOCATION_____________620__-d►___11 - --StI'eAt-_-I---StOCktOIl---_----_-----------_- - ------------------------------- -------- Owner's Name-------------------------------------- ----Camillo--Yor_s-e ---------------------- --------------------------------------- Phone-----No-------------------------- Address------------------------------------- ------------------------Address-------------------------------------- -----------k-------- Rox---608. ------- tQ_ckton------------------------------------------------------------------------------- Contractor's Name---------------------------------------Ds---A-•----PARRISH---8c---SQNS_j---- NC• •A A z -._._- Phone-----9-"-"9307---------- Installation will serve: Residence I[ Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: •01 Number of bedrooms [3 Number of baths ❑. Lot size------ t___nT----x__65t____________---_ Ry�+ Water Supply: Public system [nCommunity system ❑ Private ❑ I Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe K Hardpan ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well-----NQ1no_Distance from foundation--------1Qt' _R___Br:LGPk,, KI No. of compartments-----------�------------Capacity----900---Galsize---56-1x3_6I-x63 iquid depth 52" a Cesspool: Distance from nearest well-----------------Distance from foundation---------------------Lining material------------------------------------- F1Size: Diameter--------------------------------------Depth------------------------------------------------------- Privy: ---:------- ---------------------------------------Privy: Distance from nearest well-------------------------------------------------Distance from nearest building ❑ Distance to nearest lot line __'_ �I ______________________________ ! Seepage Pit: Distance to nearest well___NOne-------Distance from foundation--------- Distance to nearest lot line__-___10__-__ s EX Number of pits---------I--_----_-Lining material--g_-Tl_c_!Bx'}�iSi�C Diameter----------33!------.Depth--------20=----------------- rc A -Disposal Field: Distance from nearest well----- ram foundation-22--__-______Distance to nearest lot line------lot___ Number of lines-----------1--------- --------Length of each line---------75!-------------Width ,of french---------------24.t............ Type of filter material___lP--- Rk----Depth of filter material--------1$"_ Remodeling and/or repairing (describe):------- Nex--inst5ilatIgn------------------------------------------------------------------------------------------ ------------------------------------------------------------- - ---------------------------------------------------------------------------------------- I hereby certify that 1 have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. 'D. Ae Parrish & Sons Inco • (Signed)___'D_* -------------------------------------------------------- By: ----------------------------------------------------- (Ovxr Contractor] 8r---------------------------------------------- -----------------------------------------------------------(Title)---- Estimator---------- (Plot plans, showing size of lot, location of system in relation to wells, buildings, etc., must be filed with this application). FOR DEPARTMENT USE ONLY. i APPLICATION ACCEPTED BY-------------------------------------------- -�� DATE---------------f- 3- - --- - ----------- ------------------- . REVIEWEDBY------------------------------------------------------------- ------------------------------------------------- DATE------------- ------------- BUILDINGPERMIT ISSUED------------------------------------------------------------------------------------=- ---=---------- DATE------------------------------------------------------------- Alterationsand/or recommendations----------------------------------------------------------------------------------------------------------------------`-------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•------------------------------------------- ------------------------------- ---------------------------------------------------------------------------------------------------------------------------------•------------------------------------------------------ ----------------•---------------------------------------------- ------------------------------------•--------...----------------------------------------------- ---------------------------- PERMIT No.-___�1-3------ ISSUED----'_-_�-3_-"__�_ _________(Date) FINAL INSPECTION BY______ _ _ ----------- -------------------------------------- Date-------------- -------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street Stockton, California ES-9-2M 9.50 W=1639