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10 '50 APPLICATION FOR SANITATION PERMIT Permit No. 1' - (Complete in Duplicate) /d ' Date Issued ---- 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------ 1 59 W. Haze1to>b - Owner's Name-----------Susi- ------e---Tapp--------------------------------------------- -------------------------- Phone--------------------------- as above Address Same---- - ---- ----------------------------------------- Contractor's Name-Tarri sh & Sons Inc HO 3-.5947 --------------------------------------------------------------------------------- ---------------------------- --------------- Phone Installation will serve: Residence ® Apartment House ❑ Commercial ❑ Trailer Court ❑ Mot,l ❑ t Qh r El 140 x 30D� Number of living units: -1---- Number of bedrooms -------- Number of baths -------- Lot size --------------------"------___"---_-----.._.__-"----___-__ Water Supply: Public system ® Community system E] Private ElDepth to Water Table 3- -1- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobet3 Hardpan ❑ Previous Application Made: Yes ❑ No [IC New Construction: Yes ❑ No ® FHA/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 ----__."-"----.--__-__"-----_..-"_""-----__-_"-". Exi[gting No. of compartments--------------------------Size-------------- ---Liquid depth---------------- -------._Capacity----------------------- Disposal Field: Distance from nearest well-----------------Distance from foundation--------------------Distance to nearest lot line--------_------__ ExiWting Number of lines----------------------------------Length of each line------------------------------Width of trench.------------------------_--------- \ Type of filter material--------"----------------Depth of filter material---.-------------------Total leng#h.--____---_--_----------.-----"_----_-___ Seepage Pit: Distance to nearesi well.---N�n_------_-Distance from fAAundation---la1.------��tance to nearest lo��_.1 _ _ -__ [� Number of pits------------------------Lining material-------I'OC1------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 Remodeling and/or repairing (describe)-------- ---------------------------------------------------------------------------------------------------------------------------------- -------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------I---------------------------- 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 Local Health District. P Parrish & Sons (Signed)--- -------------------------- ----------------------------------------------------------- -------------------------(Owner and/or Contractor) By: B111 Wright Est Y ------- - - - --•-----------------------------------------------------------------------------------------------(Title)------------------------------------•---------,----------------- (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--------""r,R_0------------------------------------------------------------------------ DATE---------d-Q'"7_5 REVIEWEDBY-------------------------------- ------------------------------------ DATE BUILDING PERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE Alterations and/or recommendations:-----------------------------------------------------------------------------------------------"------------------... ------------ - ---------------- I - Q�OE - �. '�---`------------------ -.-`► ... � `'''----- - --�-------------------- ------ ---------------------------------- ------- --•---- - -. - --- --- - t t f --------------------------------- 2 ------------- ------------- -------- i FINAL INSPECTION BY:- - -------- A JDate i r SOAQUIN OC L H/EALTH 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 Revisea 1.57 F.P.CO. k