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r APPLICATION FOR SANITATION PERMIT Permit No,2-13----r1_._P. y [�° (Complete in Duplicate) � Date Issued Application is her y 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----------3601�3605 E, Mairi Street; StodktOn -I-------------------------------------------------------------------------------------------------------------- Owner's Name--- - ` Whitesearver ------------- Phone--6"'6755----------------- --&Uft----- -------------- ---- - ------- Address________________________-733_ ",`'« 00 E. Main Street .. -- --------------------- -- ---- -- -•-------- D A PARRISH & SONS INC Contractor's Name--- --•-•---•----------------------- -.----- -----------------------------------------s------------------------------------- Phone-----9..g6o7---------•--- Installation will serve: Residence [] Apartment House IN Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: ___3__ Number of bedrooms ___3__ Number of baths 2�____ Lot size ___ 5 x__?10? ` s Water Supply: Public system El Community system fl Private& Depth to Water Table -------- ft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe 99 Hardpan ❑ (� Previous Application Made: Yes ❑ No [4 New Construction: Yes ❑ No ❑ Drain o4ly We' TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) t Septic Tank: Distance from nearest well _Distance from foundation---------------------Material_____.______.____________.___________________- ExIlsting No. of compartments--------------------------Size--------------------------------Liquid depth--------------------------Capacity----------------------- (� Disposal Field: Distance from nearest well Distance from foundatiojo#_______________Distance to nearest o�tMGne________________. i (] Number of lines-------------- --------------------Length of each line------------------------------Width of trench-----------------------------__-... Type of filter material____1i'u___Rk---Depth of filter material---1-8n------------Total length---------N.1_________________________ Seepage Pit: Distance to nearest we[f----------------------Distance from foundation--------------------Distance to nearest lot line-.__.--_._.._____ ❑ Number of pits----------------------Lining material----------------------.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):___This is only location possible for leach drain and --------- -- ---an---improvement--on--exi------ condition, _ The well Is- a--new -13:02--- - --- ` --------1ob-.--- -------------------- -------- --------- ------------------------------------------------------------------------------------------------------ -------- -------- ------ - ---------------------------------------------------------------------------------------•-------------------------------------------------------------------------------------------------------------- hereby certify that I have prepared this application and +hat the work will be done in accordance with San Joaquin County ordinances, State laws, and rules and regulations of +he San Joaquin Local Health District. (Signed) A. PARR --IH- -&- ----- -- ------------ - -------- ------- ------------------ Contractor Estimator -A (Tit-le) - ------------------- - By:------ -----�- (Plot plan, sho g size of lot, location of system in rela on to wells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY- ------ ----------------------- ---------------------------------------- DATE---- REVIEWEDBY------------------------------ - ------------------------- ---- - - ------------------------- DATE -c�-•-------------------------------------- BUILDING PERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE------ -----------Z rAlterations and/or recommendations----------------------------------- ------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------•-- --------------------- -------------------------------------------------------_------------------------------------------•---------•-•------------------------- FINAL INSPECTION BY: V— ----------------------------------- Date------- --------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 914 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2M 9-51 Revised W-2100