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FOR OFFi U r. <br /> �.r <br /> / • I. <r , <br /> ------------------------------ <br /> APPLICATION FOR SANITATION PERMIT Permit No. . _2- <br /> (Complete in Duplicate) <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 described. <br /> This application is made in compliance with County Ordinanc No. 549. <br /> JOB ADDRESS AN LOC ----� <br /> Owner's Name. ---- ------- -------------------------------------------------------------- ------------------------ ----------------- Phone.................---................ <br /> Address........... ............. <br /> I Contractor's Name-----Q-------- 'w-------S----'TZ - <br /> ------------------------------------------------------------ ----------------•---- Phone................................... <br /> __...--••---••-----••----•-•-•------•-------------------------•------•---•-••-----------.--------• -------------•-•---- <br /> jInstallation will serve: Residence Apartment House.❑ Commercial ❑ Trailer Court (] Motel ❑ Other ❑ <br /> Number of living units: Number of bedrooms ._.,Number of baths ---j--- Lot size fGQa______________________ <br /> Water Supply: Public system n---Commuriity system ❑ Private ❑ Depth To Water Table _./-u ft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe er--H'ardpan ❑ <br /> Previous Application Made: (If yes,date.........__---______) No New Construction: Yes [T""No ❑ FHA/VA: Yes ❑ No <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: `+ <br /> o,septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Se T nk: �j Distance from nearest well_________________Distance from foundation................__Material.....................-_.......................... <br /> f No. of compartments-------------------------Size--------------------------------Liquid depth--------------------------Capacity....................... <br /> Disposal Field: Distance from nearest well---7--------Distance from foundation._/0_r_________Distance to nearest lot line.-43 ....... <br /> .-4Number of lines-----I_________ ________ _______Length of each line----Zia.-`__.._._...._....Width of trench.,ZY..`....................... <br /> Type of filter material._.?Qc_A�----------Depth of filter material.jr y............Total length____..`._•9_ <br />