Laserfiche WebLink
FOR OFFICE USE: <br /> APPLICATION FOR SANITATION PERMIT <br /> ' --------------------------------------------------- ' <br /> (Complete in Triplicate) Permit No: ..... <br /> ------- --•----------------------------------------------- <br /> -----------------__-___.__-___. ------------------------ This Permit Expires 1 Year From bate Issued <br /> Date Issued <br /> Application is hereby made to the San Joaquin Local Health District for ❑ permit to construct and install the work herein <br /> described. This application is made in compliance with County Ordinance No. 549 and existing Rules and Regulations: <br /> JOB ADDRESS/LOCATION © ✓ F ------------------- --CENSUS TRACT -------------------------- <br /> Owner's Name -- tdI -- -- ------- -- �7 t <br /> y Phone -. <br /> Address _._ _ ��� .�n7-�¢ll I @•� - � • . Cit --->�'1�-.1t7;7Z111-------------------------------------- <br /> Contractor's Name -- -- -- - - r---------------------------License # --�'. �j%l� �''-- <br /> /���---�-�'-�'Tf�---- - .? ��-- Phone -- ---` -a7,�---- <br /> Installation will serve: Residence'A Apartment House,❑ Commercial:❑Trailer Court ❑ ` <br /> Motel ❑Other -------------------------- <br /> Number of living units:---- Number of bedrooms __,7-----Garbage Grinder _;V0-__ Lot Size -/W_- _Z/ - -r___ <br /> Water Supply: Public System and name ---- -----------------------------------------•--------------- -----------------------------------------------Private ❑ a <br /> Character of soil to a depth of 3 feet: tSand'❑ Silt❑ Clay ❑ Peat❑ - Sandy Loam -❑ Clay Loam ❑ <br /> Hardpan ❑ Adobe•❑ Fill Material ------------ If yes, type ---------------------------- <br /> '(Pl•ot plan, showing size of lot, location of system in relation to 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 200 feet,) ` <br /> PACKAGE TREATMENT ( ] SEPTIC TANK Size-- ------------ Liquid Depth _, _�_______,_.___ Vi <br /> Capacity/02 fV'" - Type Materia No. Compartments <br /> ' Distance to nearest: Well ___ -- - Foundation _ .f__!___________ Pro line <br /> - - - - ------ -- <br /> LEACHING LINE No. of Lines ___ _______________ Length of each line------JV9�_.__.__- Total Length ,__11241f--________-___ <br /> 'D' Box Type Filter Material 140c7c1.5----Depth Filter Material -- <br /> t Distance to nearest: Well _r`- <br />