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FOR OFFICE USE: <br /> .... <br /> APPLICATION FOR SANITATION PERMIT,_0 . <br /> 7a; .�5•% <br /> {Complete In Triplicate) Perm o. ...................... <br /> ` Date Issued <br /> ........... This Permit(Expires 1 Year From Dot*lssutid -. <br /> - <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and Install the work herein <br /> described. This application is oracle in compliance with County Ordinance No. 549 and existing Rules and Regulations: <br /> M <br /> +. ''J r/a'] <br /> 1. ., / -. �`..ld, <br /> JOB AQQRE55/LOCATION J.ej'1N- !.! ._ .... ...... . -•-- -- '1------.....CENSUS TRACT .......................... <br /> �.. ` <br /> Owner's Name ............. : '.. ............................................_..........:. ..............Phone e�' `•• ,� .�------ <br /> Address ------...._.C_ -.f `�'.: �t.~. .-- <br /> CitI dI <br /> --------------------------------------------------- <br /> .. <br /> ! <br /> •-- ! .... .:........ # � <br /> .. --- •-- �_ _ ...6Contractor's Name 7.., <br /> Installation will serve: ,� Residence 14 Apartment House Commercial OTraller Court C) <br /> Motel Q Other <br /> �. M -------•.... ............ <br /> Number of living•uriits:'°".'___... Number of bedrooms ..-.Garbage Grinder ..._.`:.... Lot Size <br /> Water Supply: Public System and name ........... =----------..... .. _................---------------------------------------------- ..........Private <br /> -...--Character.-of-soil to a depth of 3 feet: Sand t'] Silt:0 Clay ❑ Peat❑ Sandy Loam 0 Clary Loam ❑ <br /> Hardpan 0 Adobe 0 Fill Materlol ............If yes,type............................ <br /> Plot plan, showing size of 'lot, location of system in relation to wells;,.buildings, etc, must be placed on reverse aide.) CQ ` <br /> NEW INSTALLATION:- {No.septic.tank or.seepage pit permitted if }public sewer_is,available within 200 feet,) 00. <br /> PACKAGE TREATMENT [ ] SEPTIC TANK ] Size-------------------------L..................... Liquid Depth ........•................. <br /> f <br /> Type ...... No. Compartments ---............ <br />--�• ----- Capacity ----�- •-----..._-- T --------------=----- Material.�.-----..__. ......_ <br /> A, <br /> Distance.to�nearest: Well ------------ --•- `Foundation . ................... Prop. Line ....................... <br /> LEACHING LINE [ j No. of Lines ------------------------ Length of each'line------------:.W.-----.------� ,Total Length <br /> 'D' Box.......:..... Type Filter Material ----------- --------Depth 411ter.Material�. ....._..,................................. <br /> Foundation_ Property Line --_�T._ <br /> Distance to nearest: Well ......----•-•-••-•-•-- ----.----�-_-:---•---•- :. <br /> SEEPAGE PIT { Depth Diameter ...... ...-..Number ............................. Rock Filled Yes,(] , �No <br /> Water Table' Depth ...------------ -..............................Rock Size ---•- ....................... <br /> Rock <br /> Distance to nearest: Well .........................................Foundation .................... Prop -Une_---ter................._...... <br />