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FOR OFFICE USE: b. 3p'3 �"" f � ---��- - �� SANITATION Permit No. --- ---------•=-- --• .A- '----------------- - Art-LICATION�` ----------- - ------------------------ ------------------ (Complete in Duplicate)p ) Date Issued _ -------- - Jhis Permit Expires 1 Year From Date issued /application is hereby made to the San Joaquin Local Ordinance District for o a permit two-constr ue install the work hef�idescribed. This application is made in compliance with y -------------------------------------------------- Z JOB ADDRESS AND rLOC ION. s Phone-------------------------------------------------- ----- ----------- Owner's Name.. - - - -------�7 ---- -------Address one r { Contractor's k Z ' " Other Apartment House E] Commercial [I Trailer Court Me-om ❑ installation will serve: Residence E] p ��umb;-:4 the -�_-- Lot size .v��-=-�-�-67-�'----------•------- - Number of living units: `_A_- Number of bedrooms - hto Water Table . ft.Communit s stem ❑ Private Water Supply:' Public system ❑ r y y Adobe. Hardpan ❑. � GraveL[�_ Sandy,Loam,[�_ ClayYLca.m�-�NtoD ❑� - ,;.,-tCharac#errof.soil.to a-depth_.of-3..fee*:_Sand_0 FHA/VA: Yes ❑ No ❑ F New Construction: Yes Application Made: (If yes,,dote---- ,---- ---- Previous -1 No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: _ .(No4septic tank or cesspool permit+ed if,public ewer is available within 204 feet.) , � +� �1� Material.. ------------------------------------ p Tank: Distance from nearest we167- . Distance from fpund rh ---- _/ q /f a acit ,� _ e -7-- 7-�`' i ufd depth.- C P r. Septic i - No. of compartment3- --------------- ---- -Siz _ _---- r, - ". - -Distance from foundationf6.p.- ----"Distance to nearest lot line.................� Disposal Field.!t. Distance from nearest wel .. _.._ Width of trench-_.c �L!� ---- i _ Number of lines_.$__ Length of each line- ---- fy a r l Type of tfilter materia - -----Depth of filter matenaLl. ............Total length__.----•_-- - s \ r -Q_--.-..Distance to nearest lot ii 10 -__-__---Distance from foundation__ __ !i /� See age Pit: Distance.to neare well De Linin material -Sr__-•-----Size: Diameter. .--------- P Number of pits.--- ----- g � Cess ool: is� Distance from nearest weVl-----------------Distance fro foundation.---------------- lining material--------.---------------------------- �- P❑ -----Depth------------------ ----------- ---------------------Liquid Cap c• y --------------------------gals. 'Size. Diameter %"., � ••�' Distance from nearest buil in g Y------L__-_-;,1_------------- Distance ------ --- l Privy: Distance from nearest well--- ---�----- --------------------- - ------ - - ❑ ------------------ Distance to Hearts} lot`Eine-- ----- ----------------------- _ _. -•--- ------ -- --------------------------- S µ K € f Remodeling,and/or repairing describe]:.__.%. - s 0. . - ---------------- •- N -- .. r ----------------------------------------------------------:---------------------- -------- -------- ---- --------------------------------------------------------------------- - • I hereby certify that_--��jj��ave`prepaYed this application and that the work will be done in accordance wi+h San Joaquin oun y ordinances. State laws. anlfcaules and regulations of the San Joaquin Local Hea{th District. y am\ a -(Signed)--:=__,,ap iE �Ai`� Sl✓R 1C1; - ------------ ------- - --- 2915 E.Miner Ave-, , K0.6-3847 ZA -- - g P sY ---F- buildings, tc., can be laced on reverse side]. Plot plan, showing size of lot, location of system in relation +o e11s, t 1 FOR DEPARTMENT USE ONLY G DATE.. ------'V�'-�/