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F , �^ A Per if No. APPLICATION FOR SANITATION PERMIT __ -.- (Complete in Duplicate) l� -, 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. 1 603 So. Loa Anoeles Street; Stockton 7-7367 JOB ADDRESS AND LOCATION--------- = ---- - - ---- --- - - ----------------------- •-•------------------------ ----- - - ------------------------- Robert R..Wagner 5"-3411 Owner's Name-- -=--------•--------------------------- - - - - - ------------•--------•----------------------- ------------------------------------------- Phone---------------------•---_---------- Address----------------------a-------------- -- -----------343- S....Weber Avenue - • - Contractor's Name-------------------------------- PARRISH INC s Phone------.-+} £}'j---------- Installation will serve: Residence)a Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: __1___ Number of bedrooms ----2. Number of baths __1___ Lot size -------- o_t---x90.________ --------------------- - Water Supply: Publicsystem Z' Community system E] Private L] Depth to Water Table_-ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe [; Hardpan ❑ Previous Application Made: Yes ❑I No F9 New Construction: Yes I4 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----None Dist nc from foundation----4?_________ erial__---CC Brick Capacity �dC---G�c'� S No. of compartments-------z�-�------- Size�� QD- -1Y-------------Liquid depth---------------------- -- P Y------------;� ------- 54"-- eC Disp I Field: Distance from nearest well_INQnC__--- istance romRoundation__� Distance to nearest 11103__3:_._________ Number of lines.------1---- 1�e Length of each line--------------------{_-------Width of trent -T------ ---------------------- Type of filter material-_-�g-----�--------Depth of filter material__---__z _-_____-_Total length____�____________•__.________ ``,,`` None ! r r Seepage Pit: Distance to nearest well_____________________Dis#ante from f un�ation_�-______-.-___. ante to nearest 1p�l e_____l0-_____ Number of pits'-1----------------Lining ma#erial____CeC ize: Diameter--- ----------- Depth------__-----------------------__ Cesspool: Distance from nearest well_________________Distance from foundation____________---.-_- Lining material__.____-________________-____._____ = t ❑ . Size: Diameter------------------I------------------- Depth---------_,------------------------------------__..__-Liquid Capacity---7-�. ------ -----------gals. x Privy: Distance from nearest well------------------------------------------------- from nearest building-------------------------- ElDistance to nearest lot line--------------------------------------------------------------------------------------------------------------------------- W ** Former owner partially completed septic and dug Remodeling and/or repairing iidescrib�]_______________ _ _ P I ditch_ for leach dra.in.. New owners have asked-us to eompZtte tl�iis. - .... ------ •The slttiation--is riot---cariducive'--to___stxicfir;---adYiereri,ae---to---the---rec��m-endatians ' ---------- ... -P------ -------- of t .oE---1-- rth-.De artme:nt blit is a cT�;�`i�ii�e improvement t� he exp 3� �ane �E �z o-- --------------------------------- I hereby cerfify +hat 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 Joa Zin Local Health District. n {Sr ned PARRISH IN(re �. r r �r Contractor) 'g ) ---------------------------- _=- -------- ------------ ----------------------------------------- - BY� Title - Estimator - ---------------------------- { }-- --- ---- t [Plot plan, showing size of loth Iota ' n of system in relation wells, buildings, etc., can be placed on reverse side}. FOR DEPARTMENT USE ONLY Ij APPLICATIONACCEPTED BY--- ---------------- -------- ------------------------------------------------------------------ DATE_----------------- -•------------------------- REVIEWED BY------------------------------- --- ----- __ DATE BUILDING PERMIT ISSUED DATE- V --------------------------------- Alterationsand/or recommendations:-------------------------------- ------------------------------------------------------------------ ----- ... ----••-•---------•--------------------- ------------------------- ---------------------------------------- ------------------------------•-•------------------------------ -•---------------------------------- ----------------- FINALINSPECTION BY:----------- – -=-------------------------- Date.------------ ---- ------- -------------------------------------•--- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 1 300 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