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_ -� 3�f a _ APPLICATION FOR SANITATION PERMIT Permit No. . ____________ _ (Complete,in Duplicate) ` Date Issued "A_3l o 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. •(I:Z 3n-_,�r . o4e6� 6�-a✓�..� (Swimming pool site) JOB ADDRESS AND LOCATION__-----... ..C_IKI :-FURa� Lodi, West off Hi Wa --------------------------•------------ 99........................ Owner's Name-----------------------------------------County O f San Joa uin" Bill M1Ckie do F --- -- ------ Addrub n� Contractor : Fred Brown & Sons - ."r Lodi. 1225 So, Sacramento St. - ------ ------------------------------ -------------------------••------------ ------------------------ Contractor's Name-------------------Parrish--YnC- ---------- -------------------•---------------------- -•--- Phone...9!!!960?-- Installation will serve: Residence El Apartment House El Commercial ❑ Trailer Court [3 Motel Other � Motel park Number of-living units: -------- Number of bedrooms -------- Number of.baths .__4_ Lot size __X'P______-__3__Plus acres. r Wafer Supply: Public system$] Community system E] Private 7Depth to Water Table -------- ft. Character of soil +o a depth of 3 feet: Sand C] Gravel E] Sandy Loam E] Clay Loam ❑ Clay El Adobe N Hardpan ❑ Previous Application Made: Yes ❑ No [?; New Construction: Yes [2C No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: � e (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest w ll _ �- _�Disfa r �,from f y dation-____15_111,_--.M t - l_..-__CC Brick l bin b --- ----------------- EXX No. of compartments_.-_.... ... ...........Size_ X Liquid de th 3 ` ' 1240 Ga x F� 1-- dee q p-- ------------- -------- Capacity----- ------ -G_ is ----------- Disposal Field: Distance from nearest well-!1 ----- p Q.?...... � -_.Distance to nearest I t Milne__Acres EXX Number o-r Ines__ __ _ _ pe Length Dfrom foundation.-" f each line---100_- fes ,les Width of trench-----:- �------------- -- �' n R 1X. r .$t� l00.. Type ov filter material__ ____ __ ----------D th of filter material_______ ._ Total length------------------------------- Seepage Pit: Distance to nearest weft____5______----.---Diatancelfrom foundation___.__'_.+ ___.Distance to nearest lot line_______"__..__._.W . r c. p p - --------------Size: Diarrr4er_ ------------------.Depth-- --------------- Number of Its----------------------Linin material---�" '� `+ . Cess ool: Distance from nearest welll,______*-`'Distance from foundation..-_--__,r_ =__- Lining material________________________________ ❑ I Size: Diameter # Depth - ------------- -------- -)---Liquid Capacity-------------- • gals m _ F Privy: Distance from nearest well.______"_.___--_-_---------_-_- - ______________Distance from, ;�ares+ building. iJ ------------- it ------------ ❑ Distance to nearest lot line_-__ T_ ------------------------------------------ _ _____ Remodeling and/or repairing (describe):---__Sy�rtiem_to_Sebe rest rooms�,fbr 2lek* Sfr�iIIl1�l12E� p001, V� -- ------=---------------- - in fickle Grove Parka . . ,[ o ------------------------------------------ --------------------•--------------------------------•--- . -------•-------------------------------- -- - , -.9-----------' ------------------ -------------- . Y. . Yq • e +j--------------------------------------------------------ui - - -- herebycertifythat Ihave prepared this applicafian and t'at the work will be done m accordance with San Joaquin County ordinances, State laws, and rules and regulations of the San Joa uin Loc9l£He1alth Di3trict. (Signed)_._ ___PARRISH_ - -- ------- ---(0x"Ud br Contractor) Plot Ian, showing size of lot, ocatis' em i� relation o ellbuiid' ` By: - Title Estimator p --•----- ----- -- s, a+c., can be placed on reverse side). , FOR DEPARTMENT U5E`ONLY APPLICATION ACCEPTED BY- ----------- --------------- ------------------- DATE__��----- REVIEWED BY---------- --------------------- --- - -------------------------------------------------------------------------•- DATE----- BUILDING PERMIT ISSUED-------- A ! ' `"' - ---------------------- --------------------------------- -------------------•----------------- -- DATE---------- Alterations end/or recommends+ions:------------------- ------------------- ----------------------- I e ----- ------------------------------------------------•----------------•-----.-.------•---------- ------------------•----------------------------------- FINAL INSPECTION BY:.-,4- -- - -�> ', 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 I0-52 Revised W-2100