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FOR OFFICE USE: s f -------------- __ ------------------------------------- APPLICATION FOR SANITATION PERMIT Permit No. (Complete iri'Duplicate) --------- .------------------ ----- - ---------- -- This Permit Expires 1 Year From Date Issued Date Issued ___ __ 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. Aol�� 1 0 sTo4fl /-2_ .34.st " Duncan Rd. � mile south of LL den Rd.- on liest--side, ------------------------ JOB ADDRESS AND LOCATION --------- ------------------------a Owner's Name_____________________Ray Gliadagnol-o ----•------------------ - -- ------------------------•------- ------ Pone------------- ' --....-- •-------- Address----------_--------____________•-Route I Box 130 Linden, California Contractor's Name-------------- ?A. Parrish & Sons Inc. Phone._ `_ _=9 D7-------•- 1 ---•-----•------------•------- ------------------------------------------------------------------------------ Installation will serve: Residence ® Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ I Number of livingunits: __1--- Number of bedrooms __ 3---- Number of baths _lj_ Lot size --'-------.A,CP.x2-$a------------------------------- Water Supply: Public system ❑ Community system ❑ Private [N Depth to Water Table _6a_ ft. Character of soil to a depth of 3 feet: ISand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ® Clay ❑ Adobe ❑ Hardpan ❑ Previous Application Made: (If yes,date__..--..______.___.) No ffj New Construction: Yes M No E] FHA/VA: Yes ❑ - No a TYPE OF INSTALLATION'AND. SPECIFICATIONS: (No septic tank or cesspool.-permitted if public sewer is available within 200,feet.) Septic Tank:. Distance from nearest welL_70o---------Distance from foundation__20!__.--------Material__.----comrete--------------________ EX No. of compartments-_- .----2------------Size---------3L X --4--:------Liquid depth--.---------52—R-------Capacity------1200--g.-a Disposal Field: Distance nearest well---- .,Distance to est lot line--3,51�D __ 9idthoftrehNumbeofn -- - -_- ength of each €ire20y c ------ --....... ---* I Type of fi{ter material-__.__5,/R__..___.__Depth of filter material----.---1811-__t:Total length-------1201:________- Seepage Pit: Distance to nearest well____3.501_.______"Distance f om foundation-__-21 _k.J__._..Distance to nearest lot line__10]v------ [� r F r Number of pits------2___----------Linin material__$ R_--._____5ize: Diameter�_6_�3 Vit_...___Depth__ ---2.5-1____________________ �_ r � Cesspool: Distance°from near st well----------------- .__-. Distance from ❑ # foundation -________.Lining material_________________________________-. (? �th -------Size: Diameter---------------------------- ( -________.Liquid Capacity gals. �. Privy: Distance from nearest well---------------- --------- __ ________Distance from nearest building-------______.._______-______.___..___.._. ❑ Distance to'pearest•lot line ------------ `_------- '---------- - -------------- ----------------------------------------------------------------- Remodeling 'and/or repairing describe)--------------------II]8 aa. � 2-FO-�ga�,.__Se�7t1C__#.ank1---]t�0--a-,- -•---5? --leach and two 33_" dia...�_20s_-vertical To se ve_ w _ ''s d�z� - - _.__.._________-____ ___ _________ _ _______ ------------------ ------------------------- . w.Y _ _____ ____ __ - y . f ----------------- ----------------------__--------------_________________..__-.-__-._________________ � [ . I hereby certify that I have prepaeed this application and fhet +he work will be done in accordance with San Joaquin' County ordinances, State laws, and rules and r`gulations of the Sangquin Local Health Dis+ric+. (Signed)--_------garr-i ,h ) -- - ------ --------- " T - (Owner and/or Contractor) ---- - Plot Ian, showing size of lot, Iota+ion f system to relation to.-wells,- I J , -� Ti BY: ------------ { +le) _ }t,333113tor. -------- ( p g (O y .6tiildings, a+c., can be places) on reverse side). FOR DEPARTMENT,USE ONLY ` R6 APPLICATION ACCEPTED BY--------- - ---- ---- ; IQATE � REVIEWEDBY ------------' --------------- ----------------------- I--------x -- ------ ------------------------- DATE--------------- ------------------------------------------- BUILDING PERMIT ISSUED-------------------(--------------- - -1-3 - SA DA•TE --------- --------------------------------------------------- i Alterations and/or recommendations:---------------------------------- ---------------- _-------•-•----•-----...----------'------------------------- --- --- ---------------------------------- '-- ---- ---------------•---------------------------------- ------ -------------------------------------------------------------------------------------------------------------------- F ___________--------_-------- J FINAL INSPECTION BY: �:':Z— ------- Date- ----1... . -------- ------ ----------------------------- rAN JOAQUIN LOCAL HEALTH DISTRICT 1601 E.Hazelton Ave. 300 West Oak Street 124 Sycamore Street 205 West 9th Street Stockton,California Lodi,California Manteca,California Tracy,California F.P.G p. 3