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FOR OFFICE^USE: FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT \� (Complete in Triplicate) Permit No.__ __________,_______ Date Issued__ a _T,f - This Permit Expires 1 Year From Date Issued Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described0 This application is made in compliance ��with County Ordinance No. 549 and existing Rules and Regulations: _S, JOB ADDRESS/LOCATION_Z_ v _ __L__[__ost_�! S--- ------------ --- 'er- ------P --C- CEN S TRACT------------------------------- Owner's Name------------ - -` - -------------Phone_?-Sl_'_137 --------- Address------------------------- ----- ---------------------Cit Zi 9- z.zo Y--------- P-- - Contractor's Name______ -----__.._ ____ ___ ___ _ _ __ ----------.-License #� Phone14�6-"�1�0 Installation will serve: Residence'[ Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other---------------------------------------------- Number of living units:------- ------Number of bedrooms----- -----Garbage Grinder------------Lot Size---1Q6--- r_3d7_______________________- Water Supply: Public System and name------- --------- ----------------------------------------------------- --------------------------------------------------------Private ❑ Character of soil to a depth of 3 feet: Sand ❑ Silt❑ Clay ❑ Peat❑ Sandy Loam ❑ Clay Loam Hardpan ❑ Adobe Fill Material------------If yes, type______________________________ (Plot plan, showing size of lot, location of system in relation to wells, buildings, etc. must be placed on reverse side.) NEW INSTALLATION: (No septic tank or seepage pit permitted if public sewer is available within 200 feet,) PACKAGE TREATMENT [ ] SEPTIC TANK Pq Size--------------S---X__�__(-________--------------Liquid Depth----- _-_______.__ Capacity_A5�0_______Type____c..PZ4,-Cs_____Materiat___ ___No, Compartments 7-