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- <br /> ' s` APPLICATION FOR SANITATION PERMIT Permit No. . <br /> Com lete in Duplicate) <br /> � ( P 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 Ordinance No. 549. ���(, 1 Cr- � �t/a.t,/- d-11,r� <br /> JOB ADDRESS AND LOCATION____________________`�_d�__:©' /7/ Vim-- X� <br /> .W <br /> Owner's Name k 4"" © Phone ---- <br /> Address------------------------------------------1-10------Y-----e__e---------- ---------------------------------------------------------------------------- --------------- <br /> -11 Contractor's Name----------------------------- -- -------------------- -_- --------------------------------------- Phone-- 3 '( <br /> Installation will serve: Residence ® Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: -------- Number of bedrooms __l-__ Number of baths I____ Lot size _______-�d_X �'�_7_______________________ <br /> Water Supply: Public system ❑ Community system '❑ Private g Depth to Water Table -------- ft. <br /> Character of'soil to a depth ofg3'feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ AclobeA Hardpan ❑ <br />' Previous Application Made: Yes E] No New Construction: Yes ❑ No Z w, <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /># (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest well----E a-----Distance from foundation-----�a-------Material------- ---------- <br /> No. of compartments---- -------`Y._------Size----. 5C9 -�� --Liquid depth---------- �U ---Capacity-------�5-�--- <br /> of <br /> Dispos I Field: Distance from nearest well---.SSC ___.Distance from foundation_________-----------Distance to nearest lot line-_-____________ <br /> Number of lines.--__�_____-_�_ _.__________Length of teach mlaterial_�______ ._ __{.__.Totallengthth-------------------- <br /> trench___________Q�._________- V'+f <br /> toss \\\ 6"2� l�Si��l— <br /> Type of filter material___f_y� 1fr__Depth of ilte -/8 g <br /> Seepage Pit: Distance to nearest well----------------------Distance from foundation---------------------Distance to nearest lot line_-____----____-__ <br /> F] Number of pits----------------------Lining material-----------------------Size: Diameter---------------------- Depth------------------------------_-- <br /> Cesspool: Distance from nearest well-----------------Distance from fcundafion--- ----------------Lining material_-------__,____.-_._______._________- <br /> ❑ Size: Diarneter----------------- -------------------Depth--------------------------------------------------.-.-Liquid Capacity----------------------------gals. <br /> `Distance rom-nearest-well -=-:-_ <br />