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plication APPLICATION FOR SANITATION PERMIT Permit No. X»2 853(2) (Complete in Duplicate) ... Date Issued --- 2;S2- -- AD?(0--3-2-- Application is hereby made to the San Joaquin Local Health District for a prtrkt to construct and install the work herein described. This application is made in complia At wi# C unt pr nce No, 49. rL�tJ e �oa� 2 c Manteca---Pacific Road ' Manteca South of H Way 120; East side of Pacific Rd. JOB AQQRI=5S AND LOCATION --------- - ---• - - - ------•------------------------ ---------------------•---•---------------------- Owner's Name-------------------- M• F. MCNII11 Stkn 4F-4455 ------------•------ •-------------- ----------------------- ------------------ - ------------------------------------- Phone •----•--- Address_Same. ._._ ____-__ of Manteca Between Union Rd. & Durham Ferry Rd. Con+ractor's Name--------------------------•PARRISH--INC•------ ------------------------- -------------------------------------------- Phone 9..96Q7 - Installation will serve: Residence & Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ ' Number of living units: -__----- Number of bedrooms ...2.- Number of baths------- Lot size ___200__'_____x 6 5 _____________________ ------------ Water Supply: Public system ❑ Community system E] Private& Depth to Water Table -----3 ft. Character of sail to a depth of 3 fee+: Sand ❑ Gravel ❑ Sandy Loam Clay Loam ❑ Clay ❑ Adobe❑ Hardpan ❑ Previous Application Made: Yes ❑ No [4 New Construction: 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 w Il--50____._____Disfa c,� fq�t� u da -on__3'0_---_.____- riai___CC Brick No. of compartments------------------ -----Size-�b'- Q g `� � 8 }�gSS --Liquid depth--------------------- --- Capacity------- -- ---------- t In t Disposal Field: Distance from neares well-----------------Distance from founds •o fd.�t-.Distance to nearest_l ,line___t'__.--___-- Number of lines______________-------------- __1_11--- Length of each line-,e Width of trent • '�_ '� g 3 " Type of filter material--_1"W.___Rk___Depth of filter material_____-- ��- Total length ------- Seepage Pit: Distance to nearest well----------------------Distance from foundation--------------------Distance to nearest lot line--.__---_-_-__..- ❑ Number of pits----------------------Lining material-----------------------Size: Diameter-----------------------Depth---------.------------- ---------- Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material________------.._---._______-_.___-__ ❑ Size: Diameter------ ---------------- --------------Depth-------------------••---- -------Liquid Capacity- ------------------ - ----gals. Privy: Distance from nearest well ------------------------------------------------Distance from nearest building__----._________-__________-_.__--------, ❑ Distance to nearest lot line----------------------------•--------------- a qq��(�� If water is encountered these septic compartments Rez% hn8endfrr IIeWin As.,crie ------------ y watert-fight: . . But "vri7 be as tigYit "as possible. -----• ------- ---- ----• -- ------- ----- NOTE; This application is in lieu of appy ication for Sanitation Permit -•-----•-- -- --------------------•---- - --------- --- e natpd as No. X-27 _which >�ras re, acted by phis--_dept' tris date,__1021, 1 hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin Count ordinances, State laws, and rules and re ions of the San Jo quip Local Health District. (Signed)--------.PARPLZSH INC-e----- ---- ---- - --------(�� r Contractor) By:_--------------_-- -- ------ ---- ------- ---------- ---• -------------------(Title)Estima_tor. . (Plot plan, showing size of lo+, cation of s m in relation to wells, ildin s, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY ��99 APPLICATION ACCEPTED BY---- ----------- ----- ------ DATE--------- U.."---- 2y- - REVIEWED BY -------------------- - ------------------------- DATE BUILDINGPERMIT ISSUED---------------------------------------------------------- --------------------------------------- DATE._---------------------------------------------------------- Alterations and/or recommendations---- --- ----------------------------- ---------------------------------------------------------------•-------------------•-----•- -----------------------------------------------•----------•-------------- ------------------•----------------------------------------------------------------------------------- •---------------------------------------- ------------- ••---------------------------------------..------------------------------------------------------------------------------- --------------------------------------- -------------------------------•-- -------------------------------------------- --------------•--- FINAL INSPECTION BY:- - ----------------------------------------- Date.. .. _ 4 _._.. 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 t0-52 Revised W-2100