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APPLICATION .FOR SANITATION PERMIT Permit No. _5F/2_01 <br /> (Complete in Duplicate( /a <br /> - � •� _ Data Issued <br /> Applica+ion is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein descri ed. <br /> This application is made in compliance with County Ordinance No. 549. � Zu 1_ �v - i5. eA r <br /> r ��/ <br /> JOB ADDRESS AND LOCATION..- -Owner's Name Name----------------- ...... ------------------- ------------------------------------. Phone. <br /> Address......... <br /> = - <br /> -------------------------------•--------------------------''--I----- ------ ------ j <br /> Contractor's Name---�"----- ' =-.. t e- _--------------------------------------------- Phone__( �."2__ o`-- <br /> Installation will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court Motel Other ❑ <br /> Number of living units: __$___ Number of bedrooms -1. Number of baths ________ Lot size ____31P _ <br /> Water Supply: Public system—E] Community system ❑ Private [Depth to'Water Table -------- ft. <br /> Character of soil to a depth of 3 feet: Sand ravel ❑ Sandy Loam 5e Clay Loam 0 Clay ❑ Adobe❑ Hardpan ❑ <br /> Previous Application Made: Yes ❑ No New Construction: Yes [�lo❑ <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_ /� t l <br /> Q.______Distance from fou„dation__________-.-"____.Material--_a5-1 <br /> No. of compartments_.__2-- --------------Size-__�_.'�-_-_�"�_._-n-Liquid depth_.-a� ---! <br />