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71�'►'1� APPLICATION FOR SANITATION PERMIT Permit No. .. _ _!-.__� (Complete.in Duplicate) Date Issued Applica+ion 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. 2575 E. Miner Avenue, ,, St0ekton JOB ADDRESS AND LOCATION----------------------------------------------------• ---------------- gg Bertram Ee Wilkins HO 4=�9272 Owner's Name '-- -- ' Phone-------- ---------•- ----- J� Same Address---------------- - -----------�-�--------------------------------------•--------------------------------- --------------=--------- HO «9 07 Contractor's NamePARRISH INC.,*, Phone.... ---------------------------- ---------------------------------------------------------------------------- Installation will serve: Residence Ey- Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units-41 Number of bedrooms 2_____ Number of baths ---- - Lot size 50�t_a _ __�20_�________.'_'`"______ Water Supply: Public system Community system ❑ Private ❑ Depth to Water Table ._40 ft. 4 m Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe Hardpan ❑ Previous Application Made: Yes ❑ No [N New Construction: Yes ❑ No ❑ Drainage systema s♦I: TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) , -6 None Septic Tank: Distance from nearest well________________Distance from foundation---------------------Material----------_----------------.---------------___--. &Listing No. of compartments--------------------------Size----------------------------I...Liquid_depth---------------- ------- Capacity-----------_------------ 41 Dis osal Field: Distance from near st well--�ITOTI@_-Distance from found 8 .,t Disposal dl ]4 ��?-------•------------Distance to neare�t�l�t lines____._____.__ ( Number 6f lies-------------_1_ Length of each line------------ 8� Width of trench.-50-1------------------------- P n R _____ - _ _Total length_._-___.________________________._...____Type or filter material---- _--------------- epoiermaera I None --- 5Seepage Pit: Distance o nearest well ------ om foundation_ --- - ___.__. anteonearesoe- - II 1 CbBr'Cze: Diameter_3_3 --- 0 Number of pits----------- ------ Lining material __.__.__------Depth----- -------------------- Cesspool: Distance �rom nearest well-----------------Distance from foundation.------------___._:Lining material_-._----.___- _-_-.________________ ❑.^ ., Size:.Dia ik eter__ -----,--_--Depth---Depth---------------- ---- --- -- . -- - LiquidCapacity_. gals. z x _ - = _ - Privy: Distance -from nearest well-------------------------------------------------Distance from nearest building_____________._________________-______._. ❑ Distance to nearest lot line-------------- ------ _ - --------------------------------------- -------------- ----------- � t Remodeling and/or repairing(describe):_____________________ _ ------------ -------------------------- ---------------------------------------- ---------I-------------------------------------- --------------- -----------•------•------------------------------------------------------------ --------------------------------------------------1------------------------ -------------------------------------------------------------------------------------------------------------------•------------------------------------------------•-------•-•--------- ------------------- '4 - 8 * --- ------•------------'--------------------------- �_ ... ------------------------------------------------------------I-------------------------------------- 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 ales and regulations of the San Joaquin Local Health District. PARRISH INC e i --- -- ---- -- --- - OVs Contractor (Signed)-----------------------------------:-L:---- ----------------------------- - ( ) Estimator BY� - = �F - -------------------(Title)---•---•-------------------------------------------------------- (Plot plan, showing size of loth location of system in r a on to wells, buil ngs, etc., can be placed on reverse side). FOR DEPARTMENT U E ONLY APPLICATION ACCEPTED BY------------------------------- _ _DATE___________. '"-�` �� ----------------- ---------------REVIEWED BY----------------=- ---�G ------ �r,-..---------�-------;-:---- -2-----•- - ------ - - - -- ,;;.�, ------------ --------------------- ----------- ------------------------- ---- DATE-----------------•------•--•-------------------------------- -----= - ` ------ DATE--------------------------------- BUILDING PERMIT ISSUED._I'-------------- ------------------------------ - --• : --------------....__.------ ions and/or recommendations--------------------------------------- ------------------------------------------------------------------------------•--.......---------•-------------••------- . - Alterations -la --=--------- 11 -----•--------------------------•--- ------------� ----------------••-------------------------------------------------------------------------------------------•---------------------------------------------------------- ---- - ---------- H -------------------------------------------------._..-------------------------- -- ••----------------- - --------------- ---------------------- FINA � -- --- ---- - ---`------------------------------- Date:---- -=-------------9.—-13-=414--- --•--•----•---••------ L INSPECTION BY:.---_- - __ G��1"/ 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 : Revised W-2100