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y <br /> k <br /> ` APPLICATION FOR SANITATION PERMIT <br /> (Complete in Duplicate) <br /> ^ ' <br /> Application is 6onabv moJo to the San Joaquin Local Health Districtfo, * permit tocon,truc+nmJ install the work 6n � <br /> 8cr�e6. <br /> ` <br /> This application is made in compliance with County <br /> ^^ C}n�innnco No. S49. // <br /> �� . <br /> ' ^ ° "°"~"�" ".` '^~.~..~'~-'.---^-..---'------_-__-.--- -- <br /> � <br /> phe'3_ <br /> } Address--- __._________________ --------------------- --------- <br /> Contractor's Nmmo_. .�0�..��m�r���----------.---------_.-_- Phone ���.���_- <br /> Installation will serve: Reoidnn Apartment House E] Commercial [j Trailer | Other <br /> _� <br /> Number ofliving units: �� Number of 6odruomxJ4[ -Number of baths Lot oizo'j-01-1---u/»m'~------------ ---.-' ' <br /> � Water Supply: Public system Community system [] Private [-1 <br /> � <br /> Character of soil to a depth of 3 feet: Sand [] Gravel E] Sandy Loom [j Clay Loam t-] Clay E] Adobe>� Hardpan <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> � (N� o���� tank nr �e��n�| pn,m1ffoJ �f pu6|l* �m"�, Yaa"aO�W� �RhYn 2�0fm�fJ <br /> ' . <br /> Septic Tank: Distance from nearest.*aU°�c��---Distance from foundation------I?,-------Material .»-x-_.� � <br /> No. uJcompartments--------2�=------Capacity _ Liquid doofh --6-1-91�-.__ <br /> Coonpvn|: Distance from nearest well-----------------Distance from foundation--------------------Lining mute,oL_--_--_.------- <br /> [1 Size: Diameter-------------------------------------- -_.__--.-__._--__-_' <br /> P,ivy: Distance from nearest well-------------------------------------------------Distance from noun,,t building__-.''_--_-----__ <br /> E] Distance to nearest |o+ <br /> |lne`---__--__--.__._--. <br /> Seepu o Pit� Distance to nearest/ell--------— / <br /> foundation------ � D .�� to """,",. lot line . <br /> Num�orof .___-Uning mo+o6o| Size: Diameter '_D�p+h- ��..�____= ^- <br /> - <br /> 1 ^ <br /> Disposal Field: Dis+unc* f,om nearest we||_!�^- Distance to nearest lot line--- <br /> Number of lines-_...1 --Length of each line---- --------- --Width oftrench------2_1�----------------- <br /> Type <br /> ..----.- <br /> Ty90 of filter mah,r|mJA---AVX7i----Depth o; filter muterioL.�� �.��.-- <br /> . . - , <br /> . Remodeling and/or repairing (describe):----------------------------------------------------------------------------- __.-_.'_-____.__.____ <br /> ------------------------------------------------------------i-___-___-'___'-----__--------'--''�--------'----'----�----- � <br /> . v <br /> ��������������'��'��'����''����''�����������-����������''��'��'��'�������������� <br /> .___ ` _______.---'__'--|-.-__-�-'_--___'''--__'-__'--_''''___''--_- --' <br /> � prepared this application' d that the work will be done in accordance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health District. <br /> i ___---_----- Contractor) <br /> , <br /> __---._---..__----�--__.-..-- --,-___._--___..___-_—___.- <br /> ' U� �� ��� ��� �� �system in relation to wells. buildings, etc., must be filed with this <br /> FOR DEPARTMENT USE ONLY <br /> Alfwra+hxnnand/orrec*mmonJuMono:---_'------.--_---_--------.----_'______-.._---_____._______________. <br /> --'---'-------'--'---'---'-----''-----'------'—'-----'---------'----'-----''--'---'---' <br /> '--------'---'------''--------'-'------'-''----'-------'--------''--'----'---------- <br /> Sfmuk+on. California <br />