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t - L1_0" o I 'APPLICATION FOR SANITATION PERMIT Permit No. ..._...y a-1 Q (Complete in Duplicate) a Date issued __.�_____�l_ -'�.,� � Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. I. This application is made in compliance with County Ordinance No. 549. ►-_ ._� �.- - y t 77 -- ZeD--3 6• t JOB ADDRESS AND LOCATION. 3.L_�_Sperry"Road_1west off Sharps Ln. near R.R. Tracks + Owner's Name J.B.-_Bea1rd-•_Co!pp Ilya �T1C, -- ---- - Phone ------- ------- �" ress__ -•- g - 133`Brid e Place` Stockton Cal. Add .- ----------------------••---••------------�•---------- -- -----------------�---------------------- •----- �'---`Contractor's"Name-- `-- --" �Parrlah ---Ina._ -------.T----�-------------------------------------------- -- 9,9_60-7 x '=-------------- Phone--- ---•---------- Installation will serve: Residence ❑ Apartment House ❑ Commercial'•[&—Trailer-Court-❑—Motel-E] Other ❑ Number of living units- -------- Number of bedrooms -------- Number-tef.lbathO,-_�f"1� LA size r_i._"'_ 12_ Acres__ -------------------------- Water Supply: Public system ❑ Community system ❑ Pr' ate[29"Dip—tWto Water-Table 25_'ft— Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Lindy Loam ❑ Clay Loam ❑ Clay ❑ Adobe Ej Hardpan ❑ Previous Application Made: Yes g] No ❑ New Construction: Yes ® No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS:--4M (No septic tank or ce§spoof permitted if public sewer ivavailable within 200 feet. '+ 'F Septic Tank: Distance from nearest weil__400 1-- Dista e from foundation---1 ! Concrete Material ------------------------I ® No. of compartments __ __ Size__= 2"0 -D Liqui p Cr{ p y 2 00 p d de th Ca aut �C Disposal Field: Distance from neares#.weil_r 400' . _ _"Distan'ce-frornmfoundation____-_ -1 .3� ___._.D+stance to nearest lot line------Number oflines___ 2-_-___.__ g r rr Len th of each line__lj-0_____-_---.--___..Width of #ranch..Z�-----------------1 i n,]C'oc k -- gt' r Type of filter matetiaL --____ _ Dppth of filter material_ _-- '____._Total length_____--3Aa Seepage Pit: Distance to nearest well i--- --_Distance from 'foundation--------------------Distance to nearest lot line---------------_. ❑ Number of pits------I---------------Lining material-----------------k Size: Diameter Depth Cesspool: Distance from nearest well_______________'_Distance from foundation------------------..Lining material_____-_____-__._____._ -_ Z ❑ Size: Diameter------ I Depth------------------------------- Capacity-...---------- q ------------------------gals. Privy: Distance from nearest well________________----------_-------_-------------Distance from nearest building ❑ Distance to neares,lot line----------_-----i------------------------------------------------------- Remodeling and/or repairing (describe):---------_------S_rS-"n __for_ new_ Plant_,-_.t0 serve tO �? eq! 10 eeS 1 ----------- - p-----�--• ------------------------------------------- --------------- ------------------------------------------- ---------------------------------------- I hereby certify that I have prepared Ais 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. (Signed)----------- arrish,---Tne.---_ . M i le s,��Par'ri s - caner and/or Contractor) Sy:------------------ Title)_ PresId-ent_ ---- ---- - --• --- ---------- ' (Plot plan, showing size of lot, location of system in'relation to wells, build gs;�etc`.,`can be`placed on*re verse side). a FOR f)EPARTMENT USE ONLY APPLICATION ACCEPTED B - -------- ------r - ---------------------------- DATE REVIEWED BY -- -- ------------------------------ pATE__.� ------------- BUILDING PERMIT ISSUED-------------- I---------------------------------------------------- DATE- ---------------------------------•-------- Alterations and/or recommendations:__..i___--__-_.__-__ , ' - - ------• --------------- ----------------------------------------------------- ------------------------------------------•-------- -•---------------------•---------------------------•-------------------•---------------- •-------------------------- ,-aE4,'f - - - - F � FINAL INSPECTION BY:--------- --------- --- -- Date - --------------------------------------------------- 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 10-52 Revised W-2100