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APPLICATION FOR SANITATION PERMIT Permit No,,.,70---�._ (Complete in Duplicate) I ---�-. _i Date Issued P-7_ --__ Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This applicafion is made in compliance with County Ordinance No. 549. 2564 Turnpike Road . . .Stockton ' JOBADDRESS AND LOCATION--------------- _ ---------------------------------------------------------------------------------------------------------------------------------------------- Owner's Name------------------------------------------------CLYDE---HINDS-------------------- ----- Phone---3405--------- ----------------------------- - ----- Address.................... 2564 Turnpike Road Stockton -------------------- - - ----------------------------------------------------------------------------------- Contractor's Name------------------------------------- D. A. PARRISH & SONS, INC. 9 4647 --- ----- -- - ---------------------------------------------------------------- Phone---- !!9.6--- --------------- Installation will serve: Residence-)L Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units:!------ Number of bedrooms _3--- Number of baths -_1--- Lot size -----?...Apres_------------------------------ Water Supply: Public system ❑ Community system ❑ Private ] Depth to Water Table .---154. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Gay Loam ❑ Clay ❑ Adobe ] Hardpan ❑ Previous Application Made: Yes K] No ❑ New Construction: Yes [?; No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) {OWNER WILL IIS='TALL T_NIV, Septic Tank: Distance from nearest well 60t Distan ei fr fo nrdation----12-l--------Mat ill-Redwood Z" a. Z1 No. of compartments-_-___.2----------------size---�_-x�__X ------1 iquid depth-------� -------------Capacity----------------------- Disposal --g��_--� - Disposal Field: Distance from nearest well-7?..... --Distance from foundation-__ 12----.-.Distance to nearest to �ne_I'0._- - Number of lines____----1-_- _ -Length of each line--- Width of trench.- ---2_----- Type of filter materiall�ff---xk----.-.Depth of filter material----_1-�--_-_-.---Total length-_--1}O ______________ Seepage Pit: Distance to nearest well----------------------Distance from foundation----------------.--.Distance to nearest lot line----------------- El Number of pits----------- ---------Lining material-----------------------Size: Diameter-----------------------.Depth----------------------------------- Cesspool: Distance from nearest well-----------------Distance from foundation-------------------.Lining material-----------------_-_--._--..---_-__. I� Size: Diameter-------- -------=------Depth, = -- =- ----------.-_---Liquid Caaoit• Privy: Distance from nearest well-------------------------------------------------Distance from nearest building------------------------------ ❑ Distance to nearest lot line-------- ----------------------------------------------------------------------------------------------------------------------- Remodeling and/or repairing (describe):-----OWNER WILL INSTALL REDWOOD SEPTIC TANK HIMSELF P ISD is I I T ivy T Iii;L1 Fes'"IiFi DitAl iii �1NLt------------------------- ---------------------•---------------------------- --- - ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•-----------•-------------------------- ------------------------------------------------------------------------------------------------------------------------•--------------------------------------------------------------------------------------------------- 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. ' D A. PARR I H & SONSr INC., I (Signed) ----------------------------------------------- - ----- ----------------- OXrX�i Contractor By=------------------ ------------------------------------ (Title)---ESt3.».a.tor------ --- ---- ---- (Plot plan, show i 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 ;i3 ------------------------------------------------ REVIEWEDBY ----------------- ---------------------------------------------------- DATE----- ��------------------------------------------------ BUILDING PERMIT ISSUED---------------` DATE Alterations and/or recommendations:--- ---------------------------------------------------------------•------ --------------------------------------------------------------------- ------------------------------------------------------------------- ------------------------------------------------------------------- ----- ------------------------------- ------------------------------------------ ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- I -------•------------------------------------•--------------------------- --------------------------------------- --------------I---------------------------------------------------------- --------------------------- i F } FINAL INSPECTION BY:------- -'--------------------------------- Date--------------- -- - SAN JOAQUIN LOCAL HEALTH DISTRICT 130 Soufh American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES---9---2M 8-51 Revised W-2100