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O APPLICATION FOR SANITATION PERMIT Permit No. _T�._..._.... <br /> (Complete in Duplicate) Date Issuel t-1. <br /> 3 <br /> Applica*ion is hereby made to the San Joaquin Local Health 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 /> JOB ADDRESS AND LOCATION <br /> Owner's Name---------------------------------C./ZV,5----- -------1.0 I' ------------ Phone---- ----- - <br /> Address----------------------- 7_ <br /> - - / <br /> Contractor's Name 1 ' �n ---------------------- Phone ..... _A.�7.----- <br /> Installation will serve: Residences Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: _/__-_ Number of bedrooms3'____. Number of baths ---/--- Lot size ._._.�. <br /> Wafer Supply: Public system ❑ Community system ❑ Private O Depth to Water Table ........ ft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay am [3 Pay ❑Adobe Hardpan ❑ <br /> Previous Application Made: Yes ❑ No New Construction: Yes [:] No ❑ . <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> a septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> _._,Distance from nearest well-----------------Distance from foundation....................Material------------------------------------------------- <br /> No. <br /> -___--___---- _----_---______--__-.No. of compartments------------- ------------Size----------------------------•--.Liquid depth---------- -- ---------.Capacity-------------------- � <br /> offal Field: Distance from nearest well-.A .Q�.-Distance from foundation._�L3'.....Distance to nearest lot line..ff..... <br /> Number of lines___ I ____________------------Length of each line,.$'�O__'...........Width of trench.r�-��� --________-__ AType of filter mate ria ! R,%__.Depth of filter material__-__.fS! <br />