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APPLICATION FOR SANITATION PERMIT Permit No.��__------------------ <br /> (Complete.in-'Dupiicafe) <br /> -5-_ __.-----(Complete.in-'Duplicate) Date Issued <br /> Application is hereby made to the San Joaquin Local`Health District forya permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. . <br /> JOB ADDRESS AND LOCATION---------------------------------------------------------Corner of Collier Rd, & EuniCe Rd- Acampo <br /> -- ----- ---------Wcodbrid#y-281b <br /> Ernest L, Hamilton ----------------- Phone----- -- 8 -- --------- <br /> Owner's Name.------- ----_--- -• --- - - - - ------ ---- ------------ <br /> P. 0- Box 60 Woodbridge <br /> Address------------------------------------------------------------------------------------------------------------------------------------..------------------------ -------------- ------ <br /> D. A- PARRISH & SONS INC- 9�-960? <br /> Contractor's Name-------------- ----------------------------------------------------------------- -------------------- <br /> ----------- Phone------------------------------------ -- - <br /> j' Installation will serve: Residence [4 Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ 1Ofher ❑ <br /> i Number of living units: _— Number of bedrooms _l---- Number of baths ----'_-- Lot size _8� $-__�'��---------------------------------- <br /> 40 <br /> Water Supply- Public system ❑ Community system '❑ Private [a Depth to Water Table -------- ft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ElClay Loam ❑ Clay ❑ Adobe ] Hardpan [ <br /> ­-Previous.Application Made: Yes ❑ No New Construction: Yes [N No E] I <br /> 4 TYPE OF INSTALLATION SPECIFICATIONS.- <br /> ' (No septic tank or cesspool permitted if public sewer is available w.ithin'200 feet.) ; <br /> Septic Tank: Distance from nearest A,e,160!__-----Distan frorppfoxu�d�tion_-_�'0__------ erial---_CC _Brj.Ck <br /> O C 80b Cats <br /> A No. of c7ompartm ----------------- �"`-'"3------------3---Liquid depth---2-------------------Ca acct <br /> Size p Y - <br /> Disposal Field: Distance from nearest well-----------------Distance from foundation------------- -"----Distance to nearest lot line----------------- <br /> Number,of lines-----------------------------------Length of each line--------=--------------------Width of french--.-------------------------------- <br /> Type ofrfilter material-----------------------;-Depth of filter material_-_-------------__---Total length-------------------------------_--------- <br /> Seepage Pit: Distance to nearest well--90--------------Distanc�, ropyrqu`n�lation---9�--.-__....Ds ice to nearest Ione_---_---------_. <br /> 1 y ti -- 1 De th or minu <br /> Number of pits----------------------Lining material-----------------"___-. ae. Diameter----------_-= p e-- <br /> Cesspool: Distance from nearest well-_--"------------Distance from foundation-------------------lining material----____-----__-"------------------ <br /> ❑ Size: Diameter--------------------------------------Depth-------------------------------_-------------------Liquid Capacity-, _----------------gals. <br /> ,__ <br /> Y- '`' sante fro nearest buildin -------_--- <br /> Prry Distance from nearest well----------------- ---- .-_ --------- - g " <br /> ❑ Distance to nearest lot line------------------------ -----------....---------------------------------------------------------------------------- <br /> Remodelingand/or repairing describe In YLBlyd n area where leaching drains BTC not <br /> recommended: --• -----------------------------------------------------------•-------------------•--------------------•-------- ----------------------------- <br /> ------------------------------ - --------------------------------------------------------------------------------------------------------------------------------------------------- ------------ <br /> I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of +he San Joaquin-Local Health District. <br /> (Signed)._ D A. PARRISH & SONS INC '------ ------------------ --'- r ------ imaaty�Contractor) <br /> �.. r. <br /> T -•----- <br /> By: --- -- ---- ------- - -- <br /> (Plot plan, sho in size of to+, location of stem En relation to wells, buildings, etc., can be placed on reverse side). <br /> FOR DEPARTMENT USE ONLY <br /> APPLICATION ACCEPTED BY------------ ,e <br /> ------ DATE-----S . " 3"--------------------------------------------------- <br /> REVIEWED BY------------------------ °- DATE <br /> BUILDING PERMIT ISSUED----------------------------- <br /> - ---------------------------------,---- DATE _ <br /> ------------------------------- - <br /> Alterations and/or recommendations--------------------------------------------------- -----------------------------------"-"-------------:-------------------------------------------•---------- <br /> ----------------------- -------------- <br /> ------------------------------------------------------------------------------------------------------------------ . <br /> -------------------------------------------- ------------------------------------------------------------------------ ------------------------------------,------------------------- -------------- <br /> - ---------- <br /> -2 <br /> --------------- ----------------------------------- ----- ------- - --------- -------------- -- -- <br /> -------------------- / --- <br /> FINALINSPECTION BY:---.-""---- ------ ----------------------------------------------------- Date----- -- ------------ -------------------------------------------------- e <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> n <br /> 130 South American Street 300 West Oak Street 132 Sycamore Street 814 Tracy,acy, California <br /> "C" Street ((l <br /> Stockton, California Lodi, California Manteca, California <br /> 1�QTj`i <br /> 1 <br /> ES-9-2M 8-51 Revised W-2100 <br />