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FOR OFFICE USE: <br /> ---------------------- -,/ 'C'�` <br /> _/----------- --- <br /> .................. APPLICATION FOR SANITATION PERMIT Permit No, <br /> ----------------------------------------------- --------- (Complete-in Duplicate) Date Issued <br /> ---------------------------------------- ---------------- This Permit Expires 1 Year From Date Issued -------- <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 LOC ION 4571 ....... _rl-A--------------- ------------ <br /> --------------- - --- 0 ------------------t------------------------------------- <br /> Owner's Name----- -------------9_j:?_4Z,;E <br /> 4------------ --- ----------- ----- <br /> Address..................................Y-3; et�-/ ------------ ------------------------ <br /> Contractor's Name____________________ A",------------------------------------ , <br /> ------------------!------------------------ Phonfe,--- <br /> TlcA- <br /> Installation will serve. Residence W Apartment House ❑ Commercial-,[].- Trailer-Court.E]-,-Motel.6 Other D <br /> r Z <br /> Number of living units: -- ----- Number of bedrooms -------- Number,of,,baths--------�?I ro-f e ---- -------- ------ ----- ------------------ <br /> 7; <br /> 4 <br /> Water Supply: Public system Community system [] Private [2] Depth t;,Wafer Table ...k, <br /> ;ff <br /> Character of soil to a depth of 3 feet- Sand [:] Gravel E] SanclyUam E] Clay Loam [3 Clay [J-�4clobe)< Hardpan 0 <br /> Previous Application Made: (If yes,date_.___--__.___--_. ) NoNew Construction: Yes E]No FHA/VA: Yes [I No El <br /> x <br /> kll,"tl, <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200%feef.) <br /> - k - <br /> Septic Tank: Distance from nearest well.---------------------Distance from foundatit-- <br /> --------(__­)_-..Vatel,ia�':!!�------- --------- --------------------- <br /> 'th-------� 1 �. - .`I----' Capacity----------------------- <br /> Disposal <br /> apacif y----------------------- <br /> F71 No. of compartments-----_-- -----------Size----------- ---------------/Liquid dep�` .%` --- -­xf <br /> . .1 1'. Is 3 1 <br /> Disposal Field: Distance from nearest well.................Distance'from Jounclaf ion--- ----------------Distbince' to nearest lot line________-__.____ <br /> Number of lines ---------Z------ -------Length of�eac_h li'rie,_ ..-ti.'rAidth of trench..Af�------------------- <br /> X or/ - �1­ <br /> Type of filter material-- ____...___Depth of filter material..../x-_..______-1,Tbtal- length_._.I_-9W---------------------------- <br /> Seepage Pit: Distance to nearest well....____ .. ...........Distance fr.om-fgundation------------t_­_Di,sfeince to nearest lot line_________________ <br /> Number <br /> ine----------------- <br /> Namber of pits.-_ _1------------Lin�ng ----- Size: D ia meter'- i__ De�fh_,__,74;--- <br />