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APPLICATION FOR SANITATION PERMIT Permit No. ___7,>,_ Z (Complete in Duplicate) Z Date issued Applica}ion is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. JOB ADDRESS AND LOCATION.. p7------- � - 4X --' Owner's Name.----- _1C'/f/L L--�-• / ., _� ----------------•--- ----- ----------------- - -------- Phone------------------------------------ _ � a Address------------ !'�2 ------------------------------------------------ ------------------ Contractor's Name--- 11? 1 ------ � `-------•-------•-------•-------•--------------------•--- •-----._. Phone �� Installation will serve: Residence "Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ Number of living units: J___ Number of bedrooms __/--- Number of baths ._-___ Lot size _____ C`-, L=------------------------------------ Water Supply: Public system ❑ Community system ❑ Private O--Depth to Water Table -6--oft. Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe E!j--Hardpan ❑ Previous Application Made: Yes ❑ No [ New Construction: Yes K?-No [ - TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank or cesspool permitted if public sewer is available within 200 feet.) Septic lank: Distance from nearest well____ f U_._ Distance from foundation- �__10___. Material--- ----- _ ____________ p A - Size � G �- 34--------Liquid depth------C=...---------Capacity---F� o �". No. of compartments ._-___ .___ i r Disposal Field: Distance from nearest well---- Distance from foundation___. .?... ...Distance to nearest lot line_________________ Number of lines---------------- - Length of each line__________ _r_.__.Width of trench______-?____4�.`--___________ �r -f Type of filter material___�._�___-s.9'Depth of filter material-___F°_.�......__.Total length______...��__