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FOROFFICE SE: f/.'- - APPLICATION FOR SANITATION PERMIT ------------------------ ----- - Permit No. --------------- - ----------------- -1 - � :... (Complefe•in Duplicate) + ` Date Issued This Permit Expires 1 Year From Date Issued "�"� Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. i This application is made in compliance with County Ordina e-No. 549: JOB ADDRESS AN YCATIO .". - ----- -- _ --- Owner's Name -- - -- ------ - Phone--,,*_A013.7-f- Address------------_------- � ------- j -------- ------- ------- --------------•------------------------------------------------------•-----•----------- Contractor's Name +.. . 'ham -- ------------------------"- Phone" Op.7. Installation will serve: Residence Apartment House ❑ Commercial [] Trailer Court ❑ Motel ❑ Other ❑ Number of living units: '.t.---- Number of bedrooms _-Z--Number-of baths.-1----- Lot size ? -K__l.S_?J_- Water Supply: Public system.,[] Community system ❑ Private ❑ Depth to Water Table 7.,5 ft Character of soil to a depth of 3 feet- Sand ❑ Gravel ❑ Sandy Loam ❑i Clay Loam ❑ Clay 0 Adobe Hardpan ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: ruction: Yes ❑ No �, FHA/VA; Yes ❑ No Previous Application Made: If es,date_ .. ) No New Const pp ( y `� _ . (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Sep❑d� tS7 a'�Cr No} of compartments}-well - .--Distance ance from foundation--------------------Material ----------------- --------------------- - - --- -.-Liquid depth--------- -_ -- --------Capacity------ Disposal Field: Distance from nearest well... ".__ --"Distance from foundation--- �.."---Distance to nearest lot line---";j.-------- El 91(t,54 IV 6 """".❑91(t,54IV6 Number of,lines------------------ ------"-"--- Length;of each line------.---._-_�=5-----------Width of trench..---------c�-------------------- ---------- ----------------- Type of filter material- � rial---_ld