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APPLICATION FOR SANITATION PERMIT Permit No. ... J_ P.--._ <br /> ! !� (Complete in Duplicate) bate Issued <br /> glication is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> s application is made in compliance with County Ordinance No. 549. <br /> JOB ADDRESS AND LOCATION------------1---/_&O ------7—--- ` _ <br /> ------ <br /> Owner's Name----------JR-o-- ---------i"\t--. •. �� t -- --- ----------------------- ----- ------- Phone_ <br /> Address-.--- X21 --------�------------ --•--�----/------- -- / <br /> Contractor's Name----------- _ ___ -� ____ -VC C- Phone. ._/' C <br /> Installation will serve: Residence Apartment House ❑ Commercial ❑ Trailer Corr ❑ Motel ❑ Other ❑ <br /> Number of living units: _" _ Number of bedrooms Number of baths A___ Lot size _..__ 1__________________________ <br /> Water Supply: Publics stem ❑ Community system ❑ Private ❑ Depth to Water Table -------- it. <br /> Y Y Y p <br /> Character of soil to a depth of 3 feet: Sand Gravel E] Sandy Loam Clay Loam [] Clay ❑ Adobe❑ Hardpan ❑� <br /> Previous Application Made: Yes E] No New Construction: Yes E4Y- ❑ FHA/VA: Yes ❑ No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Ir <br /> �y <br /> Septic Tank: Distance from nearest well_.�aQ----Distance from foundation__!�G!_____._._.Materia f __ ________ _______________ <br /> No. of compartments---Z______------------Size_ __ K.# Liquid depth__.` _- _._�--____Capacity____00�______ <br /> x Z/ ggsf O <br /> Disposal Field: Distance from nearest well_1-D_p_s-_Distance fr5m foundation__,2j0__`___Distance to nearest lot line---f_._.. <br /> Number of lines____ __ Length of each line___6_Q_ <br />