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FOR OFFICE USE. APPLICATION FOR SANITATION PERMIT <br /> FJ s� <br /> - Permit N CE...._ <br /> (Complete in Triplicates { <br /> ............................................... <br /> .............................. .. This Permit Expires ] Year From Date Issued. Date Issued:/0t7 I� <br /> Application is hereby made to the San Joaquin local Health District for a permit to constrict and install the work herein <br /> described. This application is made in compliance with County Ordinance No. 549,-and existing Rules and Regulations: <br /> :..::.......CENSUS TRA .... <br /> ._.. <br /> er's N me .. X ... .......... ---.......Phone .. ... <br /> .....____---...*Ci -........................ ...... <br /> Contractor's Name __ A._ C4?. ..............:...........................License # ..__...._ .............. Phone .Zz. 7.6, <br /> Installation will serve: Residence❑Apartment House Commercial&#railer Court 0 <br /> Motel 0 Other................... ..� - <br /> Number of living units_____________ Number of bedrooms ............Garbage Grinder ......... Lot Size .................. <br /> Water Supply: Public System and name ............Private ❑ <br /> Character of soil to a depth of 3 fest: Sand{] SIIto Clay ❑ Peat❑ Sandy Loam o Clay Loam <br /> Hardpan (] Adobe Fill Mcterial If yes,type ............... ............ <br /> (Plot plan, showing size of lot, location of system in relation .. wells;buildings,' etc. must be placed on reverse side. <br /> NEW INSTALLATION:". (No septic tank or seepage pit permitted If public sewer is available within 240 feet) <br /> PACKAGE TREATMENT { ] SEPTIC TANK+-jf� . _acs z Liquid Depth ..... `f..�.....--•-.- <br /> Capacity tY��O. Type -/- -- ---. Materiai'.�y No. 'Compartments ,............. <br /> i Distance.to nearest: Well __��!_� ......Foundation .,/t�.�........._ Prop. Line _ ............ <br /> LEACHING LINE { J No. of Lines ..._/...--------_--.-- Length of each Dine.._1-//.�--.----------Notal .length .. ......................... �- <br /> 'D' Box i1,1A...... Type Filter Material ._..._._....Depth Filter Materia} ..`7................................... <br /> . Foundation:, ,1... Line—. <br /> / <br /> Distance to nearest. Weis.`4P0 �..�--...__....._ _Property Line <br /> SEEPAGE PIT { j Depth 1;Z5-------- Diameter J.1�5...... Number .../.................. ... Rock Filled Yes 9?/,'No 0 <br /> Water Table Depths ................................. Rock Size .. <br /> ``.. <br /> Distance to nearest: Well ----�U� .......................Foundation ./Q.- <br />