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FOR OFFICE USE; --------------------------------------------------------- _________________________R__,-___.----_--____-____._--- APPLICATION FOR SANITATION PERMIT Permit No. ..1.. ---------------•---------------------------------- (Complete in Duplicate) l-• ._ __ This Permit Expires 1 Year From Date Issued Date issued ._ __:��: Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. w This application is made in compliant with County Ordinance No. 549. C_ 00 i4A-00 S7" 0 JOB ADDRESS AND LOCATION-__ `---: ---=' ----- - �rrd-----�jt------ %z___,�_'S_��-�---------------Al ____ - Owner's Name------ = ' ----------------------------------------------- - -------- -- Phone..7�� -' f l-- Address-------------------------------------------------/---- --------------------•-------------------- ------- f Contractor's Name , _'.rce � LPJ /�/ l� f ` �yc J �[-------------- �_ __� _� �------------ ------- Phone-_ �l_4_4_ Installation will serve: Resider Apartment House ❑ Commercial ❑ iTrailer Court ❑ Motel ❑ Other ❑ Number of living units: __/__ Number of bedrooms __� _ Number of baths _ .-- Lot size ___________________________________________________________ Water Supply: Public system ❑ Community system ❑ Private K Depth to Water Table--_-!j'_0_ ft. Character of soil to a depth of 3 feet: Sand 0 Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe❑ Hardpan ❑ Previous Application Made: (If yes,date--------------------I Nojf New Construction: Yes ' No ❑ FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic Tank: Distance from nearest well----SJ_f___Distance from foundation____!0__f_____.Material____�-��`2--------------------------________ 7'ael y (� No. of compartments---------:,�-------____Size-_�.!'S�_�______,___Liquid depth-----�f�,-..---------Capacity___f.7_�%cJ_ Disposal Field: Distance from nearest well__--5= -------Distance from foundation____69-1------ Distance to nearest Number of lines______________ -----Length of each line---------9�9__�_�---------Width of trench_________ ------------ Type ___-___---Type of filter material_____i�rCA/-