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-�-� Permit No. . -__--••- -------- �� APPLICATION FOR SAN1TATl�N PERMIT _ y (Complete in Duplicate) Date Issued -S ��pplication 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 Coun fy,Ow ance No. 549. JOB ADDRESS AND LOCATION-------- --------- ------ko So_- Wagner,------------------------------------- Phil --Stockton- -- Stockton - -- - - � 7-7763 Owner s Name----------------------------- eTOlfl._MA_!Phi-------- 454 lips---------------------------- - ----------------------------------- ----- Phone--�-------------------•------------- n 4 4 Sop Wagner Address----- ----------••-•---------------•---- ----••-----------------•---------------- =9-960'r Contractor's Name---------- --- pARftISH IN Co Phone----------------------------------- - Installation will serve: Residence Aparfinent House ❑ Commercial ❑ Trailer Court El Motel ❑ Other ❑ 60 t x 150 r Number of living units: __._ Number.of bedrooms -2---- Number of baths ---.__-_ Lot size -----------__ _ ------•-----------•---------------------- Water Supply: Public system [ Community system❑ ' Private ❑•. Depth to Water'Table -4.0-- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe Hardpan ❑ Previous Application Made: Yes ❑ No K] 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--------_---.---_----..-----------_---.-.------ Size------------- -----------------Li Liquid de th--------------------------Capacity-•-------------------- 10 ---lO t FS �ti No. of compartments---------------- ---- - q 10 a Disposal Field: Distance from nearest well --__.-...-:Distance from foundatiopL- -�_____________Distance to nearest line--------__-----. Number of lines_- -----___-.1 e Length of each line-----------arlgl>f•------Width of tren�, -Gi--------------------------- - Rk De th of filter material-----------------------Total length_-:..-------------------------------- .-;.,� Type of filter material--__ __________ ___ p Seepage Pit: Distance to nearest well 9�--------------Distan e S�mgou ion- -- -----.---.--[)i,ijance to nearest J� Iijne---------.------ U r ize• iameter.... --JJ --- -------.Depth-------------------------- Number of pits-_�-----------':-_.Lining maters I----------------- ---- Cesspool: Distance from nearest well-----------------Dista e from fod tion--------------------Lining material-----------.--------.----_---.-.----. ❑ Size: Diameter---- ------- ---- -------------------Depth-------------------••------------------------ -Liqu'sd Capacity-.--------------------------gals. -_--_-----------------Distance from nea�esfbuildin `�` Privy: Distance from nearest well--------------------- --- g " - - r Distance to nearest lot line------------------------------------------------------------------ ------------------------------------------------- Remodeling and/or repairing_(describe):--------------------------------------------- --------•--------------- -- ---------------••------------ ------------------•--------------------------------- --------------------------------------- i �/-------------------------- -•----------------------------------------------- ------------------------ ----- 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 Loaal-Health District. (Signed)----- PARRISH xN -'° ------------------------------------ ( Contractor)\ ,,- (Signed) Title Estimator --------------------- (Title) (Piot 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--P-------- DATE- — ----- -------------------------------------------- ------------------ REVIEWED BY----------------------------- ------------------------ ------------------------------------------------ DATE-- _'—----------------------------------------------- BUILDING PERMIT ISSUED DATE Alterations and/or recommendations:------------------------ -------- -----•--------------•------•------•------ ---- - ---------- --------------- -------------------------------------- n " Date.------- __ -IA- ------------------- FINAL INSPECTION BY:------ ----'----------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 13o South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California E5-9-2M 10-52 Revised W-2100