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FOR OFFICE USE: <br /> . V <br /> -------------------- ----------------- --------- <br /> APPLICATION FOR SANITATION PERMIT Permit No. . <br /> (Complete in Duplicate) Date Issued <br /> ------------------------------------------ --- This Permit Expires 1 Year From Date Issued 02-(_ 10,0--2-7 <br /> Application <br /> 0,0-2- <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 Ordinance No. 549. <br /> U. <br /> JOB ADDRESS ANDLOC ION_�.�_--y-- _ <br /> Owner's Name------1--_f�''-� -- -----• ------------- e <br /> --------------- <br /> ----------------- --- <br /> C'- la-Q � Phone <br /> ---------------- <br /> Address <br /> Contractors Name--- - __ ne <br /> ----------------------------- --- <br /> ---- -- - -- -- -- ------- - -- -- - - ----------------------------------- <br /> installation will serve: Residence [Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other ❑ <br /> Number of living units: ---I--- Number of bedrooms -_/---.- Number of aths I---- Lot size'- ------------------------- <br /> Water Supply: Public system E:1Community system El, Private depth to Water Table ft, <br /> Character of soil to a depth of 3 feet: Sand E] Gravel ❑ Sandy Loam 0. Clay Loam ❑ Clay Adobe ❑ Hardpan ❑ <br /> ---.-I No New Construction: Yes ❑ No ❑ FHA/VA: Yes ❑ No ❑ C <br /> Previous Application Made: (If yes,date-------------- ❑ , <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank.or cesspool permitted if public sewer is available within 200 feet.) <br /> Septi k: Distance from nearest well----;F4! Distance -from foun'd�ation----/-a_..-_--- Materrial--- ---------------_--__----Q. <br /> No. of comprtmens..----- Y Size_- r nA ---Liquid de th---- --- Ca acity._ -o---- <br /> a , <br /> / -r- dation---?ae-_`_.._-.-.Distance to nearest lot line- ------ <br /> - ----- <br /> Dis o Field: Distance from nearest well----- from foundation�0a Width of french.-___-�--------_--------------- � <br /> Number of lines---------- -------- Length of each line----_----------._-.----- <br /> Type of filter material------ ..--Depth of filter material ---.--1q,---------Total length--------1_h-d------------------------ <br /> r t <br /> See/pe Pit: Distance to nearest well------ from foundation_--J-L'---__--_--.Distance to nearest lot line--- ----------- <br /> 77C <br /> '��_ <br /> Number of pits---------' -_ l- <br /> .Lining materia ---4�- �- Size: Diameter-.-_--33---------Depth----.�S-_ <br />