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APPLICATION FOR SANITATION PERMIT <br /> 1 (Complete in Duplicate) <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County Ordinance No. 549. <br /> �o o � l Fcs - <br /> JOB ADDRESS AND LOCATION--- p/ - = -��1 �^-�f rd� , <br /> Owner's Name 'L= ' 4�C Ca �� `'Z3 of �►�JP, -GG G phone------a--- <br /> :-------- -- <br /> Address--------__--------------------------------------- - ----------------------------- <br /> � ------------------------------- <br /> Contractor's <br /> : lr <br /> Contractor s Name-------------------------------- �'"' rf---------- Phone----------------------------------- <br /> Installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court Motel ❑ Other II <br /> Number of living units: Number of bedrooms ❑ Number of baths ❑ Lot size________________________________________IL------------------_ <br /> Water Supply: Public system ❑ Community system ❑ Private ❑ <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ardpan <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 fe t.) � <br /> Se ti ank: Distance from nearest well_________________ a ionMat ri I______:_-_______._______` 7 � ' <br /> p �T _ ;y - u-liquid .�— <br /> I�j No. of compartments--------ry=-----------Capacity--•'.!•o --------Size-- - 3 - depth --------------- <br /> Cesspool: <br /> ------- ---Cesspool: Distance from nearest well------------=�-____Distance from foundation_____________'" ning material_____::_-- ____ -------__3------- S . <br /> ❑1 Size: Diameter---=--------- ------Depth--------- ------------------------------------- <br /> Privy: <br /> ----- -----------------------------Privy: Distance from nearest well-------------------------------------------------Distance from nearest building----------------------lCounty <br /> -----_-- <br /> ❑ Distance to nearest lot line------------------------------------------------ <br /> I <br /> __________________________________________ __1 Seepa p Pit: Distabnce of nearest well______________________Distance from foundation___--_________.Distance to nearest lot lin _______ <br /> p - -------------------Lining material---------------- P <br /> ----- Size: Diameter-_-? �-,-------.De th------------�` ---- -- <br /> Dis al F ` i ante om ea st w Il_____ _ ___-___Distance from foundation______ Di tante t Barest lot li __ rNu of line _____ Lengt e li e_________ ____ _ idt o tr -------Type of filter material_.________ th of filter m ___-__ <br />