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p Z �1 APPLICATION FOR SANITATION PERMIT $ rmit N°• = --s --o f 7 -- -- (Complete in Duplicate) ` 7 fy, Date Issued _____ Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. �'P[I ,.• TJr1�.�2f. - JOB ADDRESS AND LOCATION /�6( la,2 -4�' ` ~'� `" ---------------------------------------- e - Phone-- � Owner's Name------------------------------------- - - -- Address----------------------- -------------------- -- ---------- -.-----------------------------------,--------------- Contractor's Name_---------------------•-•-------_-- ---------------- Phone--- Installation will serve: Residenc Apartment House ❑ Commercial ❑ Trailer Court ❑ Moferl,g Other ❑ Number of living units: _/_k Number of,bedrooms 1_T-," Number of baths ---y: Lot size __- ----------••- Water,Supply: Public system ❑ Community system 'El Private 5 Depth to Water Table t.^ Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ Sandy Loam ❑ Clay Loam ❑ Clay ❑ Adobe; , Hardpan ❑ ` Previous Application Made: Yes ❑ No j. New Construction-. Yes ' No ❑ 1� f�TYPE OF INSTALLATION AND SPECIFICATIONS:If - (� (No septic tank or cesspool permitted if pu lic sewer is available within 200 feet.) �! Septic Tank: Distance from nearest well_ f��__-__Distance from f ndation_____ gip_ G��p�'----- _,3�__ _Li Liquid de th-_f --------------Ca acit __aGsJV�r_ No. of com artments_____.___--v"_____Size _ _ _ q � �Wel _'___Distance from foundation___ __.Distance to nearest lot ime___-> ____. Disposal Distance from nearest well Number of lines-----/---------------------------Length of each line__v57. Width of trench_ _ "___-_____________ Type of filter material__ __ _ -_Depth of filter material__.ft --------------Total length__gj�i-Zt.