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APPLICATION FOR SANITATION PERMIT Perrriit No.,;?-v`--------------------- (Complete in Duplicate) S Date Issued Application is hereby made to the San Joaquin Local Health 'District for a permit to construct and install the worn herein described. This appiica+ion is made incompliance with County Ordinance No. 549. let, house on left On Morse Rd, 94. .tre -�. ��rE�p R east of Hi Way 99.. JOB ADDRESS AND LOCATION__ s---.-.--BAK- -335_•F, * ----------------------------- --------------------------------------------- Kenneth H, McElroy Owner's Name ----------------- --- - --------------- Phone-------s4362------------ Address------------- Same ---------------• ----- -------•---------------.-----------------... - ---------------•----------------------------------------------------- ---------- --------- ------ - - ii Contractor's Name---------------------__ ' A� Parrish & S©ns Irici ---------------------------•------------- Phone.----9---- -9-60 .. Installation will serve: Residence [X, Apartment House ❑ Commercial ❑ hailer Court ❑ Motel ❑ Other ❑ _ Number of living units: --- Number of bedrooms _-2___ Number of baths Lot size ________75talOt- ' ------------------------------ k Water Supply: Publics stem Community system C] Private EX Depth to Water Table _ 5*f+. ,,Q Character of soil to a depth of 3 feet: Sand ❑ Gravel E] Sandy Loam E] Clay Loam E] Clay ElAdobe] Hardpan El �+{� # Previous Application Made: Yes ❑ No 9 New Construction: Yes ❑ No ❑ Drift supplement :~ TYPE OF INSTALLATION AND SPECIFICATIONS: I (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well-----------------Distance from foundation--------------------Mafierial_.________-________________-____________ EXt4ting No. of compartments--------------------------Size--------------------------------Liquid depth-------------- r Disposal Field: Distance from nearest well_----------------Distance from foundation-------------------.Distance to nearest lot line-___--__-___----- EXUting Number of lines-----------------------------------Length of each line----------------------------- Width of trench I Type of filter material-------------------------Depth of filter material-----------------------Total length------------------•----- ------------•----- Seepage Pit: Distance to neareswell_.100-�_.......Distance from foundation___20_. .______.Distance to nearest lot lin ______ ----- 14xNumber of pits----------------------Lining material----CC---------Briqke: Diameter ..---- -------------- Cesspool: Distance from nearest well-----------------Distance from foundation--------------------Lining material---------------------------------- %, ❑ Size: Diameter-------------------------------------Depth- -------- ---------------- ------ ------- --Liquid Capacitl gals. Privy Distance from nearest well-- -----------------------------------------Distance from nearest building_-.---________--_..___--_- ❑ Distance to nearest lot line Remodeling and/or repairing (describe)----------------------------------------- ---------------- ------------•-•---------•----------------•------------------•-----•--------.---• ------•----•-------------•------------ -------•-•-------•-----------------------------------•--------------•---------------•---------------------------•------------------------------------------------------ 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. Si ned D. A. PARRS & ONS IIUC` . { g ] or � . _ Contractor _ �- - ! (Plot plafi, ----------------- sh g size of lot, location of sys+em i relation wells, buildings, etc., can be placed on reverse side). � �' FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY ----------------------------------------- ---------------------------------------- DATE_S� -------------------------------------------- BREVIEWED BY------------- DATE ,•-• --------------------------------------------------------- 1 UILDING PERMIT ISSLIED------------------------------------------------------------------------------------ --------------•-- DATE---------- Atera+ions and/or recommendations_______________ -- ---------------------------- ---------------------•--------------------- ------------------------------------------------------------------------------- -------------------------------------------- --------- ------------------------------ ------- '/I— FINAL INSPECTION B - _-.--__-- ------------- Date------------ -- --- -- 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 r'