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1/4-x--=-- APPLICATION FOR SANITATION PERMIT Permit No. <br /> ------ (Complete in Duplicatel4 <br /> --------------------------------------- =---------- :: This Permit Ex fres 1 Year From Date Issued Date Issue <br /> Application is hereby made to the San"Joaquin Local Health District for a permit to construct and install the work herein described. k <br /> This application is made in compliance with County Ordinance No. 549, <br /> JOB ADDRESS AND LOCATION__.-__..s "� <br /> -A - <br /> Owner's Name.......... ---- -��---•---.�'�_ --- ------••------•.............. <br /> --- ------------------------ --------•--------- <br /> Phon�.... f'(..... <br /> Address . $1-.� 1 <br /> ----- --------•----f i •---•---• ---•--.s� <br /> ------------------ <br /> Contractor's Name___________ ___ ___ L� t <br /> Installation will serve: Residence Apartment House E] Commercial Trailer Court [3 ' Motel��e <br /> ❑ Other ❑ <br /> Number of living units: .--/--- Number of bedrooms _ <br /> = Number of baths ____ __ Lo} size ._.._._S" <br /> Cheer Supply: <br /> Public system Corrirriunif s s}emK�! <br /> t <br /> at pp y, y y ❑---PrriveYe❑—Dep-h to Water Table .:...... f#. f <br /> Character of soil to a depth of 3 feet: Sand-❑—Grave!-E]--Sa dy Loam <br /> Y ❑"Cley'L`oam ❑ .Clay.[] Adobe Hardpan ❑ <br /> Previous Application Made: (If yes,dote.___________ No New Construction: Yes ❑ No 5� FHA/VA: Yes ❑ No,K <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> {No septic tank or cesspool permitted if public sewer is available within 200 feet.) I <br /> Dis <br /> Septic Tank: Nnt of compartmentsance from + I e11--=------ ----Dze nce3 from foundatiLln-urd-i.---,"""-.Material..------------•-•------ <br /> Disposal Field: Distance from nearest well__ i q depth ----------------------- ....................... <br /> '�:riLL.:.Distance from foundation _-/P..........% Distance to nearest lot line_.- __ _ <br /> a� Number of lines.__...i_ ___ <br /> q- -----Length of each line_ -- 1 :--- �/ti/idth of trench---4 "'�-..--•--- o' <br /> L" Type of filter materia- <br /> p£pth of filter material-----19'_"____.To}al1-""_-_-. �] <br /> Seepage Pit: Distance to nearest well__ � - <br /> `-7o.e-1..f�____Distance from foun atlon__....J_�_ ......Distance to nearest lot line__...'._-•-- <br /> 91 . - _... . . .�,.,�•._ _._ �., . __ <br /> Number of Pits-------.I_______ InIC -ng rnate.rla� ize: Diameter__. _ <br /> Depth. ,s:r----------•-- ` s <br /> Cesspool: Distance from nearest well----------------_Distance from foundation____ <br />