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FOR OFFICE USE <br /> _- ------ 71. - ---- - <br /> APPLICATION FOR "SANITATION PERMIT <br /> Permit No. 7.. <br /> ------------------------------------------------ {Complete in Duplicate} <br /> Date Issued ----- <br />-;=---------------_.-_-----------------------------._.- This Permit Expires 1 Year From Date Issued <br /> --.....��.:-__6 7i <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. <br /> � 3 .._ <br /> JOB ADDRESS AND LOCATION_, ------ • ....- <br /> Owner's Name -... = --------------------------•------------------------------------•----•-------------- Phone.................................... <br /> Address-------- = - ------------------------.......................... ----------.............----•--------------------•---•------...----•----------------•-•-•••...-•-----•--•-•-- <br /> Contractor's Name...------a4z _t./,-----------------•---------- -------------------------------------------------------------- Phone.............--.................... <br /> Installation will serve: Residence [Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: ----/-- Number of bedrooms -3--- Number of baths „__ Lot size ------ISP x.__1.��.¢------------------------- <br /> Water Supply: Public system Community system ❑ Private ❑ Depth to Water Table "ft. <br /> Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe ej—Hardpan ❑ <br /> Previous Application Made: {If yes,date--------------------) No Nevi Construction: Yes �o ❑ FHA/VA: Yes ] No E�-- <br /> rTYPE OF INSTALLATION AND SPECIFICATIONS: s <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> a i �� <br /> Septic Tank: Distance from nearest w -------Distance from foyndation..�__.__________.Matanal__�.................:.........................p <br /> No. of compartments------ ------------- ----Size....---- x_ ./D Liquid depth-----y.. ---------.-_--Capacity-->Z ?49� <br /> Disposal Field: Distance from neai-esf well 1-4e --------Distance from foundation.-/4>-----------Distance to nearest lot line................. <br /> Number of lines.._.._'L_--.----_-_---_-.--._Length of each line---- ---------------Width of trench-..... .y._`:.............. <br /> Type of filter material...! 0. .---------Depth of filter material----le....-----__.Total length_-_--_-_?'��'................_-_ <br /> Seepage Pit: Distance to nearest well-1,04---------------Distance f�om foundation--/e-_-.---_•.--Diitance to nearest lot line.:___..-.- <br /> Number of pits----_--- <br />