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APPLICATION FOR SANITATION PERMIT <br /> f <br /> (Complete in Duplicate) <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 o. 549. <br /> _ � __j ..ve-'--_----•---------- <br /> JOB ADDRESS AND L CATION___ _-_-- ---------0----------- ------- <br /> Phone__LP___'�----_ ------I <br /> Owner s Name x0/ y - - <br /> QAddress---- - Ipmo�- �rdlFf3 Y f/ ` --------------i- <br /> - <br /> ---- )� .� Phone__579 �l-�-- <br /> Contractor's Name------ --- � <br /> t. <br /> Installation will serve: Residence Apartment House ❑ Commercial`❑' Trailer Courf'❑rMotel ElOther t <br /> Number of living units: Number,.of 'bedroomsA Number of baths -a- � <br /> Lot size____ 0---X-•� f I-------- i <br /> 1 l ter Supply: Public system Community sysj P..r.ivate-❑ <br /> Character of soil to a depth of 3 feet: Sand [I Gravel ❑` Sandy Loam ❑ Clay Loam [:1 Clay ❑ Adobe ardpen ❑Q <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if'.public sewer is available within 200 feet] <br /> ._ k rt._ <br /> 'S6ptic Tank: Distance from nearest well_-_,:.._'__'__..Distance from foundation-_-_______r-------Material___________________ � <br /> ___________-______ �___- n <br /> (:❑ --No. of compartments----------=--------------Capacity--------------------f Size---------- <br /> - -------------------- depth-------------- - <br /> Oesspool: �_Distance,�from,neare'si well _y______ d 4 <br /> Distance from foundation___________ _______Lining aterial_ -______________-___- <br /> ❑ % rt/ 4 --------------- <br /> Size: Diameter,--; <br />