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",,, -APPLICATION TM v 1� FOR SANITATION PERMIT Permit No. (Complete in Duplicate) Date Issued __ - _/ -�Ad---- -a N& Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described.. 4 This application is made in compliancerwi+h County Ordinance No_ 549. - t 13004 W,� Mi.ch'i an Stockton JOB ADDRESS AND LOCATION -------------------------- -------------�-- ......� ----------...-----•---------•-•----------••----------------------------------------- Owner's Name(Dealey,owner)IA-« F. Toccoli., General Contr 6-6392 Phone----6--639 -------------- - 1_x-932 W. Euclid Address -------------------------------- ----•-------- -------------------- -------•------------•------------ ---------------------- Contractor's Name------------V'-------------------D-- A. PARRISH $ SONS,y---INC. "�--•--------------------------- Phone-------a!n9iQ'? -------------------------------------------------SONS.p ------- Installation will serve: Residence�f Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living un-its: __1-_- Nu ober of bedrooms .z___ Number of baths --I-- Lot size -------- __-.�/*_Acre8 ,.r Water Supply: Publics stem Community system -El A Depth to Water Table -------- ft. Peaty Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ❑Hardpan ❑ Previous Application Made: Yes ❑ . No X] New Construction: Yes [X No ❑ I TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is availab`l-e within 200 fee+.)�-_,., 4 Septic Tank: Distance from nearest well 20Q-R_ Distan e fro foundation_10 --._-__--_.M trial-Ce $r1L No, of com artme"ts- Z ----- ID2 Capacity p ---------- Si, Liquid depth p Y Disposal Field: Distance from nearest well-15Q3-----Distance from foundation19t - Distance to nearest lot line----------------- Number x_.-._- Number of lin -------------- - Length of each line_-.�Q_---_-16-F------_-Width of trench_--Z4'"---------------------_- Type of filter material--1� --Rk._--Depth of filter material-----18i............Total length-------120_*----------______________ Seepage Pit: Distance to nearest well--------------------_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-------------------------------------------------------------------------------- -------------------------------=------------------------------ Remodelingand/or repairing (describe)---------------------------------------i----------------------------------------•-------------•------------------------------- •----------------------- p ---------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------- 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. (Signed) D, A.----PARR-ISH &_ SONS, INC. e Contractor �Y -•------------------------------------------- -------------- ----------------------------------------------------------(Title)--Estimator----------------------------------- (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------------------------ --------- DATE- -------------- ------------------------------------------------ REVIEWED BY ---- --------- DATE---------- BUILDING PERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE---------------------------- - ---- ------------------------- Alterations and/or recommendations--==--- -------- ---------------- ----------- ------------------------- -------------------------------------------------- ------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------- ----- ----------- --------------------------------------------------------------------------------------------- ------------ ------------- ------- --------------- --------------------------------------------------------- FINAL INSPECTION BY: L--- !ice y �1��/7 Date 0_4f J� -, =---------------------------- SAN JOAQUIN LOCAL HEALTH 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 8-51 Revised W-2100