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i <br /> FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT <br /> Arm. Permit No- ��-.C---. -cArm.— . <br /> }------P-` ----------17 ---- (Complete in Triplicate) <br /> ------- ------- -���-----t-1 f?A1----- -This Permit Expires 1 Year From Date Issued Date Issued =:----� <br /> ------------ -------------------- <br /> , <br /> Applicatiori is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein <br /> described. This aplicati n is �y ' y�gmpliance with County Ordinance No. 549 and existing Rules and Regulations: <br /> '-� -2 7' <br /> • . JOB ADDRESS/LOCA <br /> ------ <br /> ------ = CENSUS TRACT <br /> - -- <br /> ., r •. . : ------------------- one <br /> ' Owners Name -�:.---� - ---- -- --� - - - - - - -- -•--------- - - <br /> City --------------------------------•---- <br /> IAddress ;.�__P�_�� -- __- - -- ----- - �---------------------------------- <br /> r Contractor's Name ��.r/ =License -0 _�a_129 Phone - <br /> 1 1f <br /> Installation will serve: Ya Residence Apartment House,❑ Commercial.:❑Trailer Court x❑ � ,` f <br /> Motel ❑Other -------- ----------- ------------------ <br /> -- <br /> ---------------j <br /> Number of bedrooms �___--Garbage Grinder ____- Lot Size __ -------------------- <br /> Number of living units:_____ ��___ - <br /> ¢ /` <br /> Water Supply: Public System and name ------------- ---------------------- ----- --------------------------- Private 1 <br /> e <br /> Character of soil to depth of 3 feet: Sdnd❑ Silt;❑ Clay ❑ Pea❑ Sandy Loom .0 Clay Loam.0 <br /> 1 �:.. __. . �..�; <br /> Hardpan ❑ Adobe Fill Material ------------ If yes,type ____--_____---------------- <br /> ; <br /> (Plot plan, showing size of-100-location of system in relation to wells, buildings, etc. must be placed on reverse side.) <br /> Py p p p public sewer is available within 200 feet,) <br /> NEW INSTALLATION: (No septic tank or seepage it permitted <br /> ie�#� -------------- Liquid Depth ___`T--------------.-----y � <br /> PACKAGE TREATMENT [ SEPTIC TANK' <br /> ' No. Compartments -____ ------•_ <br /> -_ _ _ Material '1L-�- <br /> . ,� Capacity/,;?c_6____ TYPjt,� <br /> -_ l c '�j�� <br /> Distance to nearest: Well - Q--�_----------.".--Foundation -_. --------- Prop. Line Is---_� <br />