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FOR OFFICE USE: <br /> APPLICATION FOR SANITATION PERMIT <br /> ------------------- Permit No. �6 <br /> (Complete in Triplicate) ---- <br /> --------------------------------------------------------- This Permit Expires 1 Year From Date Issued <br /> Date Issued <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 made in compliance with County Ordinance No. 549 and existing Rules and Regulations: <br /> r 3 .1�.e-rteC i 9 <br /> JOB ADDRESSAOCATION 34-3 30-r- -- rz = -- --}- - -- I s.l. gra---.S_L_C, CENSUS TRACT ----5-`_-4_1 <br /> c u - ..�� `1 - � ------------- ------------ <br /> Owner's Name � � ------Phone ------------------•--.._---•-•-••--- <br /> AddressTV--- 0-;L5---------- --------------------------------- ------ city � _�---------------------------------------•----------- <br /> r � � <br /> Contractor's Name ----------- ----- _____ ___ _ - License # _f_fff_V�7__ Phone ----------- .................. <br /> Installation will serve: Residence Apartment House^❑ Commercial ❑Trailer Court ❑ <br /> Motel ❑Other -------------------------------------------- <br /> Number of living units:------ ---_ Number of bedrooms ___-3------Garbage Grinder ------------ Lot Size _____________________ <br /> Water Supply: Public System and iname ------------------------------------------------------------------------------------ ---------------------------------Private <br /> Character of soil to a depth of 3 feet: Sand'❑ Silt❑ Clay ❑ Peat❑ Sandy Loam -❑ Clay Loam <br /> Hardpan ❑ Adobe ❑ Fill Material ------------ If yes,type ____________________________ \ <br /> (Plot plan, showing size of lot, location of system in relation 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 /> 01 or e -, sr <br /> PACKAGE TREATMENT { ] SEPTIC TlANK'[6f;,� Size_X_m__wx_,�%--------------------- Liquid Depth - ___ -____-______-- <br /> Capacity Type _4e •_ Material_ - -- <br /> -rte---_._ No. Compartments _ - <br /> ---------------- <br /> Distance to nearest: Well ____-___.So_ <br />