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' D <br /> APPLICATION FOR SANITATION PERMIT Permit s <br /> 1 [Complete in Duplicate} r � 3 <br /> Date Issuedation <br /> l'UjAppli 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. <br /> JOB ADDRESS AND <br /> - 2s --------------------------------- ------ Phone------------------------------------ <br /> Address <br /> Name----------------•---_------------ - ---- <br /> t <br /> Address------------ Qf °%� ------- ---- ------------------------ <br /> Contractor's Name-----------------------------1 Gi1Vt p-I ------------------------------------- Phone �?' a <br /> Installation will serve: Residence ® Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: .____- Number of bedrooms -r�:_ Number of baths J---- Lot size -------ean.!P_'_---- <br /> �--"�__. --`�-•---- -- <br /> Water Supply: Public system ❑ Community system ❑ Private ❑ Depth to Water Tableft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam El Clay El -Adobe s;.,. Hardpan El ` <br /> Previous Application Made: Yes [INo-jZ New Construction: Yes [:] No r❑ � � � <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> Septic Tank: <br /> tank <br /> Distancecesspool <br /> permitted <br /> ea nearest welt public <br /> !`"_ !ti�Aista�nc..e�.,available <br /> �frorn fouhdain fion�00 '----__--.Material_ <br /> ,mss No. of compartments-------�i.______--..__Size_. <br />