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OFFICE USE: <br /> /APPLICATIONFOR .OFFICE USE: <br /> ---------- <br /> FOR SANITATION PERMIT <br /> (Complete in Triplicate) 'Permit No:__':- <br /> --------I-- - This Permit Expires ] Year From Date Issued r' Date Issued__-. <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. <br /> This application is made in compliance with County-OrdinanceNo. 549 and existing_Rules and Regulations: <br /> JOB ADDRESS/LOCATIONJ_4- ?_,?j-----(11-1 <br /> Owner's Name------- -'---PAI----- -- -----:.CENSUS TRACT-------- ------- --------------- - <br /> ..-f- ---------- ------ ----- ------------- <br /> one <br /> -. _.--- "'� - a•r..eo--'--'e ----- -' <br /> Address--..--/ �� 3 ------Ph <br /> ------------------------ -----a <br /> - -- <br /> --- --------------------City7 ------- t <br /> --------------------Zip------------ r <br /> Contractor's Namek /►1�!$1Ga� ��`,g <br /> -- -- -License #._j,OJ9.J?A._+Z <br /> Installation will serve: Residence Apartment House.❑ Commercial ❑ Trailer Court ❑ ; <br /> Motel a <br /> - ❑� Other ----'-- -- _ <br /> Number of living units. I__- __Number of bedrooms_-._ E <br /> - .___Garbage Grinder"`:.�_�-,:fLotT.Sizel.�r,��/.li�':Ld�G,_�e���_���_G�r��T <br /> Water Supply: Public System and name__ ._________._ f f <br /> ---'---------------------- <br /> ----- --'-- ----- - -- Private (� <br /> - - - -------------------------------------------------- <br /> Character of soil to a depth of 3 feet: Sand Silt Clay❑ _ ❑ Y ❑ Peat❑ Sandy Loam ❑ Gay Loam ❑ - <br /> Hardpan ❑ Adobe � Fill Material------------If yes, <br /> ' - a <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 /> PACKAGE TREATMENT [ J SEPTIC TANK A �� ° /1 I <br /> Siz� G�- , 4L� c�C =Liquid Depth _ <br /> Capacity--f-00-0--,----.Type--------- - - ' -Material---)-- - ' 3 � it - t <br /> l , '_.:_ -- No:.Compartments.- ------- ' <br /> (.14 <br /> . Distance to nearest: Well------(_o�.............. e <br /> ` Foundation , �' ------.Pro . Line---' <br /> LEACHING LINE p -- <br /> i�CT No. of Lines------- -- --------------- Length of.each line----70------------------Total Length -3- - -- <br /> I D' Box---- --=--T , <br /> ype Filter Material_____/_� -.Depth Filter Material_.__- ' .............................. <br /> Distance to nearest: Well___-_1-p e_ <br />