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FOR OFFICE .USE:,,, �s <br /> --- ------ ------------ ----------- --------------- <br /> APPLICATION FOR SANITATION PERMIT Permit No. ........................ <br /> ----------- -- -------------- -- ---------------- - (Complete in Duplicate) <br /> This Permit Expires ] Year From Date Issued Date Issued , <br /> -.__---------------------'--_-__-.._--____.__.--_-..___ <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 /> JOB ADDRESS AND LOCATION/5 �-��__.��_�-----------2400-----------------f)-�----��. <br /> Owner's Name---- Q_( _A_1'_:__1-D---------------------no-_rm.] _j__ __ _ M. Phone------------------------------------ <br /> Address 1 ;?S6 SC_1_1)_ 1_01V ESCF~)-L01V--=----------------------------- ------------------------------------•------•--- <br /> -c ---------------------------- <br /> Contractor's Name------O----•V11N ---------------- Phone----------------------------------- <br /> Installation will serve: Residence F-J'Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel ❑ Other [] <br /> Number of living units: _- ____ Number of bedrooms--: Number of baths _Y._._ Lot size ---- •------ <br /> Water Supply:I : Publicsystem ElCommunity system ElPrivate —Depth to Water TablO_S-- ft. - <br /> Character of soil to a depth of 3 feet: Sand El Gravel El Sandy Loam E] Clay Loam ©Clay El Adobe❑ Hardpan �'� <br /> Previous Application Made: {If yes,date....................I No ❑ New Construction: Yes ❑ No ❑ FHA/VA: Yes ❑ No ❑ <br /> TYPE, F INSTALLATION_AND-SPECIFICATIONS:_ <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> 1 <br /> Septic Tank: Distance from nearest well....J_9------Distance.from foundation_.--__/0_.-------Material_CV��r�T��--�� <br /> ®� No. of compartments-------- _-----_---Size--- -0Ifl._X-` -----Liquid depth_---� --. <br />