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FOR OFFICE USE: ;r <br /> APPLICATION FOR SANITATION PERMIT <br /> f 30 7-Z -__5z <br /> Ir : Permit No. <br /> (Complete in Triplicate) <br /> __-- <br /> t X Date Issued .., -/_(0 - J/ <br /> 9�? --- ---.�-� ,----_ �; This Permit Expire 1 Year From Date Issued <br /> r Application is hereby made to the San Joaquin Loca Health District for a permit to construct and install the work herein <br /> described. This application is made in compliance with County Ordipalnce t4c. 549 and existing Rules and Regulations: <br /> ----------------------- / it <br /> i 1 Y.s <br /> JOB ADDRESS/LO ATION Q-�--_ � 1�1 '- - --- 6 .....�v(--./CENSUS TRACT -------------------------- <br /> Owner's Name --------- ;-�c+l.--t`- Jj --- € - -phbn <br /> p . <br /> Address ------ ----------- Q r`'- -. City --- ........ <br /> ----- <br /> Contractor's Name .--- �-Tl- --------- --- 2 ---;- ----- ------License # L� ---- -�-1_ <br /> Installation will serve: Residence ❑ Apartment House-❑ Commercial;❑Trailer Court ij] <br /> i Motel D Other -------� = <br /> Number of living units-----------/Number of be&49oms _ __Garbage Grinder ',_�-e-1__ LotSize .......... <br /> ____.._... <br /> //fes� .Private <br /> Water Supply: Public System and name ----- -Cts" `--- _ E]4 Character of soil to a depth of 3 feet: Sand'❑t Silk] Cla E] t.Peat 0 Sandy Loam ❑ Clay Loam ;❑ <br /> Hardpan E] Adobe _ Fill Material _ If yes,type ___________________________ <br /> r , <br /> (Plot plan, showing size of lot, location of system in elation 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 -[:1 SEPTIC�AKi,� Si . STT _ __ _- _-_ Liquid Depth .__� � _. OQ` <br /> � /-� <br /> F Capacity - Type -----_ Mafierial w{•. IVa. Compartments -- ......... r` <br /> l --- f� <br /> Distance to nearest:,-Well ___.__4 _______Foundation ---� <br />