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?1 APPLICATION FOR SANITATION PERMIT Permit f_---7....-- a ,I I � (Complete in Duplicate) Q Date issued --�--,1•:----••--• 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. JOB ADDRESS AND LOCATION-----------2_33---East Alpine ----------------------- Name-------Y.....A&yar_o---------------------------------------------------------------------- ---------------------------------------------- Phone................................... Address...................E?Q0•_East---MaY1__Street ------ ------------------------- ------ Contractor's Name____ Parrish & Sons HQ ( 96©7 - -•- - - Phone Installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other gg Store Number of living units: ________ Number of bedrooms -------- Number of baths2___t_�4 �______-___.1:___blOC$-------------------------------------- Water Supply: Public system ® Community system ❑ Private ❑ Depth to Water Table '-+Q-_ 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 ® FNA/VA: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 well-----_-----------Distance from foundation_____•_______,_:__.Material.___-:__-____-____________-__-_-_,_..___--__,.. Eaistmig No. of compartments-------------------------Size--------------------------------Liquid depth_------------------------Capacity....................... Disposal Field: Distance from nearest well_________________Distance from foundation....................Distance to nearest lot line................. Existiiig Number of lines-----------------------------------Length of each line______________-_____________Width of french..--------------------------------- Type of filter material-------------------------Depth of filter material--------------------___Total length---_...................................... Seepage Pit: Distance to nearest well n-Oi e_________Distance from foundation_-_ 5'---------Qijtfince to nearest loft line-1-0-0' ExitNumber of pits--------- Lining material____ roC_:_____-Size: Diameter-----------------------Depth -_______Q_r________ f j�n `U Cesspool: g Distance from nearest well-----.-----------Distance from foundation ______ _________Lining material-----------------------------.___:........ Qll 171 Size: Diameter•------------------------------------Depth----------------------------------------------------Liquid Capacity----.......................gals. "V 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 the San Joaquin Local Health District. ned ParsOwner and/or Contractor Si( g ) Parrish & Sons - - ---------------------------------------------------- ---------- ----- t / ) By:-- -------Bill WTig--lt-------------------------- ------(Title)----Est.----------------- -- ------------------- (Plot plan, showing size of lot, location of system in relation to 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_______________ _-__ __ _ 1 -------•--------------------------- --------------• -•-- ---- cs t`�� _- � ........ - -- -------•- -::: ----------- - - -U- d t r ----•-- ------ -------------- ---------- ------- ---- ----- •- -------- ----- Y- - t FINAL INSPECTION BY: -- Date------- -------- _ --- ---------------------- SAN ' --------------•----SAN JOAQUIN LOCAL HEALTH DISTRICT 130 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 Revises 1.57 F-P.CO.