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k4jg�S1 <br /> 4�} APPLICATION FOR SANITATION PERMIT Permit No.,.Y <br /> 1�J (Complete in Duplicate) <br /> Date IssuedLLII �' <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work her deet !bed. <br /> This application is made in-compliance.with County Ordinance No. 549. t <br /> JOB ADDRESS AND LOCATION_ .- a_I.-------_ l- �- � � <br /> Owner's Name 6�14 ' ' \A//--/-I = _' �1Qn of 1�i%� �/6 - / --------- <br /> '0 <br /> 0 <br /> Address -------- --------------- <br /> - -5 ------- - <br /> s I <br /> __: �1/ ff ��c� '.------- -- _ <br /> Contractor's Name--------•-- --• --•-�-l�-1�:1.-�--�T---------•���:-�- °� �. � � - - ---- ••---•---•----•- <br /> F=-------------- ------- ------ Phone-,�ZJ•'--�-�kR7 <br /> Installation will serve: Residence Apartment House❑ Commercial <br /> , E] Trailer Court C1 Motel El Other ❑ <br /> Number of living units: --1---_ Number of bedrooms ---o Number of baths :------ Lot size <br /> Water Supply: Public system Community..system ❑ Private � De fh'to'Water Table #,0- ft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ AdobeHardpan ❑ <br /> Previous Application Made: Yes ElNo 9. New Construction: Yes ❑ No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No Septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well---__---_-- ' ` ' <br /> . --_-'Distance from foundation--------------------Material--.---.--_---____--- -.-- .- S" <br /> ❑EXjsh V4 No. of compartments------ ------------------ --•---- ----'h <br /> Size_.----•-----�------- -=---•-----Liquid depth-----•-------- -----------Capacity------- -------------- <br /> Disposal Field: Distance from nearest well------------------Distance from foundation._--- <br /> ❑F-1Lt5 t"/�a Number of lines-------- - Distance to nearest lot line---_•___.-___---- <br /> Length of each line --'---------------Width of french-------------------------------- - <br /> Type of filter material----°-- -Depth of filter material-------4--------- - --- <br /> v-.s. - •--..-- a. , 1 <br /> Total length <br /> Seep age Pit: Distance f nearest,well��\l_p_ "_Distanco frolm`foundation_-:-,TS..._-_.Distance to nearest lot line-- _--I <br /> f <br /> l j Number of pits---QN_E�/�-Lining material_sPRI i1 -_-Size: Diameter--- ti <br /> ------ ----.Depth--��-R------ ---Cess ool; 'p Disfance froim nearest well-_;------- <br />