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hPermit No. APPLICATION FOR SANITATION PERMIT \ (Complete in,Duplicate) Date Issued �! - pplica*ion is•hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described;4 This application is made in compliance with County Ordinance No. 549. t 4727 Farmington Farmi ton Road. Stockton -------------------------------------------------------- JOB ADDRESS AND LOCATION ------------------- ---- ------------ " . -------- HO 35514 James R. Ashlock ------------- -•---------------------•- --------------------------------- � Owner's Name--------------------------------- -------------------•---------------••------------- .AddrSame ----------•----------------------------------------------------------- Address-..----------------------------- ess_..._-------•--------•---------- -------------------------------- PARRISH & SONS NC. ---------------------------------------- Phone- -HO----66------------- Contractor's Name_.---•------•-----•---•------- ------------------------------------------- go7 ❑ ❑ y , Installafion will serve: Residences Apartment House F1 Commercial [I Trailer Court Motel ter . 11 Number of living units: __1___ Number of bedrooms _2_ - Number of baths Lot size ------- -- Cre•-+---------------------------- Water Supply: csY I • Public stem ElCommunity system ❑ Private [X Depth to Water Table .59_ ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ :Clay Loam ❑ Clay ❑ Adobe JgC Hardpan ❑ Previous Application Made.• Yes ❑ No New Construction: Yes ❑ No ❑ Supplementary drainage 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__:___---.____Distance from foundation__________________Material---------------.--------'.__-- ___..___-.___9 Size---------------------------•---Liquid depth--------------- ---------Capacity..----------• -------- lEXisting No. of compartments...- ----_--- , Disposal Field: Distance from nearest well------------- Distance from foundation__________________.Distance to nearesf.lot`1,ne.___--_______..- ,w (EXiSting Number of lines---------------- ------- ----------Length of each line-----------------------------Width of trench-.-------------------- -- Type of filter material-------------------------Depth of filter material_--------------------Notal length-------.------------------- --- -- �` 1 15 10 Seepage Pit: � Distance to nearest well-.3-Q0.--__---.--D+stance from foundafiion____ ...........Distance to nearest lot line._.__._____.___-_ FNumber of pits.---- ---------------Lining material Brick --...Size: Diameter---- 33"_---------Depth----39-t___-----------.----- Cesspool'. Distance from nearest well___._-_____.__-Distance from foundation....................Lining material:_.____-_.--_____._..-_.___-_____.._-. ❑ Size: Diameter ------------------------- ----Depth------------------------------ ---------- - -- Liquid Capacity gals- F-1 als. Privy: Distance from nearest well------------------------------------- ------Distance from nearest building-------------------------------------- ❑ Distance to nearest lot line----------------- -• -------- - ------- -- ----- -- ---------•- Remodeling and/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 th an Joaquin Local Health District. PARRISH &_SaNS.,__ TNC.-------_.-- -- (O Contractor) (Signed)----------- (Title). . Estimator ------------- ------------------------ -- ---- 0 (Plot plan, showing size of lot, location of system in re tion to wells, buildings etc., can be placed on reverse side). a FOR DEPARTMENT USE 3NLY + DATE •----------- --- APPLICATION ACCEPTED BY.................�� ---- - - ---- / // DATE; rf `C ------------ ------------------ ------ REVIEWED --- ------ REVIEWED BY----------------------------------- - --' -------------------------------- - - DATE--------------•---------------- ----------- -------------•- BUILDING PERMIT ISSUED----------------------- -------------- + Alterations and/or recommendations--------------------------------------------- - -- ------- ---------------------------------------------- - Date---------------- ` �-S FINALINSPECTION BY---------- ------------------------------------------------------ .—SAN JOAQUIN LOCAL HEALTH DISTRICT 300 West Oak Street 132 Sycamore Street 814 North "C" Street 130 South American Street - TCalifornia Stockton. California Lodi, California Manteca, California Tracy, F9-9-2M 149446 ATWPDO . 12-54