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�-"-�-�----- APPLICATION FOR SANITATION PERMIT Permit No,%,?,4''// (Complete in Duplicate) Date lssued/-_�`7`'--"-J`5 Application is hereby 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. 549. 42 South_ David__Stre_et:a--,_atA_ckton---------------------------------------------------------- JOB ADDRESS AND LOCATION------------ DS alt _ -- - ----------------------------------------- Phone"_2,-..2-- 2------------------ Owner's Name------------------------------------------------------------------p-- - -S Address 942 South David Street -------------------------------------------------------------- ---------•--------------------------------------------------------- Contractor's Name----------------------- - D. A. -PARRISH & �ON�+ �N�; Phone 9��6Q� Installation will serve: Residence ME Apartment House ❑ Commercial .❑ Trailer Court ❑ Motel ❑ Other ❑ . Number of living units: ----- Number of bedrooms --- .-- Number of baths -1---. Lot size -_-501xi -0-t___--_--_------------- p . Water Supply: Public system El35 Community system ❑ Private KI Depth to Water Table - "---__ ft. lus Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe M Hardpan ❑ Previous Application Made: Yes ❑ No 99 New Construction: Yes [)L No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if ublic wer is available within 200 feet.) N 4 P t .3 ] 14 Septic Tank: Distance from Weare t w _C� fr r�,fro �ougda�ion___.___.�____-----.Matettial""f'--�___B 1�Ck_. .___-____-__-" pp OO -----------Capacity---- QQ_-_GEL1S. No. of compartments------------------- -----Size_ X3�---7C- �__Liquid depth-----52.- -- Disposal Field Distance from nearest well_-. _--_Distance from foundatig�n..10 t---- Distance to nearest lot line__10"---"-- Number of lines-----1--------- Length of each line------ -------------------- -------"Width of trench------2-------------------------` Ij'_Rk- D --- 18:-------Total length------•20- ------------------------- Type of filter material_____- - _"_- eptii of"filter material__ - ! Seepage Pit: Distance to nearest well------90 ___ ---Distance from foundation----lO�_-------Distance to nearest 2t line---- �C Brick r IX Number of pits----------------------Lining materia------------=------ -" Size: Diameter---.33 ------------Depth---- ---- Cesspool: Distance from nearest well-----------------Distance from foundation---_--------------.Lining material---------------------------- '-gals. ❑ Size: Diameter- ----------Depth----------------------------------------------------Liquid Capacity---------------------------- Distance from nearest well----------_-----" -----------------Distance from nearest building-_.-_-__-__------______------------_-_-. Privy: -------- - - I ❑ Distance to nearest lot iine------------------------------------------------------------------------------ ---------------------- Remodelingand/or repairing (describe):----------------------------------------------------------------------------------------------------------------------------------------------------------------- ------- ------------•--•--------------------- --------- --------------------- --- ----- ---------------------------------------------------------------------------------------•------=------------------------------------•-------------- I hereby certify that I 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. A. PARRISH & SONSs----INC------ --------------- -------------'-------- --------------- --------{� Contractor) (Signed)- �J Estimator By' --fes (Title) (Plot p n, owing size o�fj&ot, �Iocion of system in relafion to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY-------- ------- DATE---------------------------------------------- ------------ REVIEWED BY---------- ------------------------ DATE --- �--�------------------------------ ------ DATE BUILDING PERMIT ISSUED_____________,: -_---.:--- -- ---------------- Alterations and/or recommendations- ----------------------------- --------------------------------------------------__-------------I----- ------------------------ --------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------ ------------------------- ------------------------------------- -----------------------------------------------------------------------------------------------I—--------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------- ---------- ---------------------------------------------------- --------------------------- ---------- -------- --------------------------------------------------------- ----------------------------------------------- - ------------------------------- - - -- ------------------------•----------------------••------- ------------------------------------- -------------------- - ------------------- --------- - '~ Date----- ------------------- --------------I------------------------------------- FINAL INSPECTION BY:--•-----------------------"----------------- r SAN JOAQUIN LOCAL HEALTH DISTRICT 134 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2M 8-51 Revised W-2100