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r� APP ATION FOR SANITATION PERMIT Permit No. 3 .�.5_._ . V— .;z ~� / (Complete in Duplicate) I/4 4 Date Issued on is ApplicatiLr(by made to the San Joaquin Local Health District for a permit to construct and install the work herein described. , This application is made in compliance with County Ordinance No. 544. JOB ADDRESS AND LOCATION.._._2_t02_ South California Street, Stockton ----------------------------- ----------------- Owner's Name---------------------------------------Pa:ciflc Clay Products Corp-------------------------------------------- Phone----------------II------------------ Address-----------------------------------------------2402 South California Street, Stockton ---------------------------•------------------- --------------------------;;----------------- Contractor's Name---- D, A4 PARRISH & SONS, INC' Phone 9^96-17 0,11, Wash Installation will serve: Residence ❑ Apartment House ❑ Commercial MC T,3ail r P c I her .J] hof Mill, base Number of living units: -------- Number of bedrooms .------- Number of baths ________ Lot size ______ ____ _ _ __________________________________ Water Supply: Public system 4W& Community system 0 PrivatAWQ)epth to Water Table 40... ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam❑ Clay Loam ❑ Clay [ Adobe [ Hardpan ❑ Previous Application Made: Yes ❑ No E�- New Construction: Yes ] No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest w L_ ___Dista ftp fo atin_ $ __ �__s��Vrial C_C+__-_Brick _____I.O©Q__6�� ` No. of compartments---------------- -- --Siz j 0*--yd: ep- Liquidp p y----JL.O---- -------- O"� O" 1 Disposal Field: Distance from nearest well------------------Distance from foundation_________________Distance to nearest lot lint_________________ ❑ Number of lines-----------------------------------Length of each line-----------------------------.Width of trench---------------- ----------------- Type of filter material-- Depth of filter material-----------------------Total length-------.-----_--.-------C----------------- fit~ See age Pit: Distance to nearest well____ ---One Distance from foundations ___________- . fanc to nearest to in I___: ----------- Number 101____ 1 CC Brie 01@1 2 . Number of pits----------------------Lining materiaICC--- Diameter-----------------_--_--Depth--------------�r�--------_---__--- Cesspool: Distance from nearest well-----------------Distance from foundation______._____-___..Lining material------------------11---_.____________ ❑ Size: Diameter---=----------------------------------Depth----------------------------------------------------Liquid Capacity-=---------------I.1f----------gals. Privy: Distance from nearest welL_________________________.________.______.__-___Distance from nearest building------------.-------, �i-------------____. j [] Distance to nearest lot line______________,_--_-----_ I -- ---------- Remodeling and/or repairing (describe):-----------------------------------------------------•-----------------------------------------------------------.--•-• ------- ---------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---.------- T ----------------------- -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------11----------------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin Coun ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. �yA a PARR T & 0111,5 I C / ---------- r o 17 , (S�gned} --- —` �i�n - - Estimator -----------------(Plot pl n, o ing size of lot, location of system in rel #' n t wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY------------------- - ------ DATE---------- -------------- ------------------------------------------- REVIEWEDBY----------`----------------- ---- ----------------------------------------------------- ------ DATE---------------------------------------- BUILDING PERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE----------------------------------------- Alterations and/or recommendations:------------------------------------------------------------ ----------------------------------•--------------------------------------------I----------------- 11 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•-----------l----------------- ---------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------ 4-11y- -le j, �` /�1� ----- Date-------- FINAL INSPECTION BY--- ---------- -- --- --- --- ----------.------------=- --�-------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" SflIlrIee? Stockton, California Lodi, California Manteca, California Tracy, Californi5 ES-4-2M 8-51 Revised W-2100 '� r