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rvK VI-IA t U5E: <br /> - <br /> ---------- <br /> -0 Q..__` -. APPLICATION FOR SANITATION PERMIT Permit No. ..... .__... <br /> �_. <br /> --------------- ------ .11 1..._. <br /> Application (Complete in Duplicate) <br /> Ication Al- This Permit Expires i Year From Date issued Date Issued <br /> pp Is hereby made fo'fhe San Joaquin Local Heaith 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 /> it e/ <br /> JOB ADDRESS AND LOCATION-..__.____ ._ y.G� j_ <br /> 1{- `--"---••------•-------•-------• --- <br /> Owner's Name________ ___ __• . <br /> ------------------ <br /> Address.............. <br /> ...... <br /> - - <br /> Contractor's Name___ � .:.._ _ r Phone <br /> Installation will serve: Residence P�, Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: ��. .___ Number of bedrooms .'____ Number of baths .I-__ Lot size __.g;;5__ ° <br /> Water Supply: Publics stem i Community system ❑ Private ❑ Depth to Water Table 90ft. <br /> Character of soil to a depth ofl3 feet: Sand E] Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ AdobeX Hardpan ❑ <br /> Previous Application Made: (If iyes,date__________ _________) No ❑ New Construction: Yes ❑ NojM FHA/VA: Yes ❑ No ❑ <br /> TYPE: OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) ; 1 <br /> !I <br /> 5 is Ta Distance frm nearest well_________________Distance from foundation__....__...__..__.Materia!_..____..._:_.._.___. <br /> D osaF lel Distance fr�Ipartments______-_-_-'---_------._Size------- Liquid depth-------------------------Ca aci <br /> No. of compartments <br /> or <br /> tt P ty---------------------- <br /> pm nearesf well.-1-_!-per_Distance from foundation.._ <br /> Distance to nearest lot line__ <br /> Number.of Miines___.-__� �_ Length of_each line___ f <br /> q <br /> --------------- <br /> � Width of trench.G Type of filter material Cc---Depth of filter material----: ----Total lengfh-------- <br /> Q <br /> •--------- <br /> V <br /> Seepage Pit: Distance to�nearest well_4�.-____Distant m-foundation__ �j <br /> c .d______._.Distanc� to nearest lot <br /> Number of'pits_'_.-I............ _Lining material. b <br /> S-___---Size: Diameter--- _. ..._--..Depth__....--- - -•------- <br /> Cesspool: Distance from nearest well-------------_- from foundation.-., ______-_._-.-.Lining material_I------------------ <br /> ❑ Size: Diame`er__. d----------------------------Depth----------------------------------------------------Liquid Capacity--------= <br />