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FOR OFFICE USE: APPLICATION FOR SANITATION PERMIT <br /> ---------- Thisfermit Expire's 1 Year From Date issued <br /> Application is hereby made to the Son Joaquin Local Health District for a permit to c6nstru nd install i the,work he <br /> de in compliance with County Ordinance No. 549 and existir�g,,,Rules an R gulafion <br /> described. This application is ma U 7, <br /> Contractor's Name ----y <br /> Installation will serve: Residenc E]Apartment House E] Commercial :E]Trailer Court 'El <br /> Number of living units------ ---- Number of bedrooms -----Garbage Grinder,->----"'Lot Size ------ <br /> ci <br /> Character of soil to a depth of 3 feet: Sand' Silt El Clay 0 PeO <br /> jF t:be placed .on reverse sidel <br /> (Plot plan, showing size of lot, location of system in relation to we6, buildings, etc. mus' <br /> NEW INSTALLATION- (No septic tank or see�i lij I - I X Depth /--------- 4) <br /> PACKAGE TREATMENT SEPTIC TANK�14� �S i z --------- Liquid <br /> om <br /> LEACHING LINE [1�4 /11 <br /> 'D' Box .7------- Type Filter Materia I . <br /> Distance nearest. Well --- --------- Foundation -----I�P-------------rProperi ------------: t <br /> SEEPAGE PIT Depth t <br /> REPAIR/ADDITION(Prev. Sanitation Permit# I - <br /> ------------------------------ <br /> (Draw exisfing and r1equired�idclition on reverse side) <br /> I hereby certify that I have prepared thisi�applicatiah and"thai the work will be done in accordance with Son aq <br /> County Ordinances, State Laws, and'Rules and Regula_�Ions of the Son Joaquin Local Health District. Home owner or licen <br /> sed agents signature certifies the following: 1-11, <br /> "I certify that in the perforniance of the work"for which this permit is issued, I shall not employ any person in such manner <br /> as to bec subject..to'Workman's Compensation laws of California." <br /> (if other th6n owner)� <br /> OR DEPAIRTMENT/SE ONLY <br /> / -DISTRICT— <br /> E. H. q l''68 Rev. 5M <br /> � � <br />