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FOR OFFICE USE: -- " ` r FOR OFFICE USE: <br /> 11 APPLICATION FOR SANITATION PERMIT <br /> ----- - ----------- ---------•------- ------ Permit No.---7-27�_S3-U <br /> i <br /> (Complete in Triplicate) <br /> --------------------------- ------ `------- <br /> �I f Date Issued <br /> ---- ---�- ----��, <br /> _-----_-------------'_____--- This Permit Expires I Year From Date,lssued <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 and existing Rules and Regulations: <br /> y P.7Q l�Q r------------ CENSUS TRACT - <br /> JOB ADDRESS/LOCA N-T. <br /> T p -- -------- ------- e ; <br /> Owner's Name � ---------- y <br /> .2 ,.?Y_'---City /� _ ---- - <br /> } Address--------- ___ _--�_____ - ------ ----- ----- ------ 6-_GC [ f ZAP � T �T,-®. <br /> r - � � <br /> Contractor's Name--'- -- Lam" ------License # 0� 7 / Phone ---------- ---}`3.� <br /> - -- -- <br /> Installation witl serve: : Residence �artment House Commercial ❑ Trailer Court ❑ i <br /> t ._.,-Motel ❑ Other-=------{----------------=-- ' <br /> Nulmber,of living units----------- -----Nuri ber of bedrooms-. .__.Garbdge Grinder---------=--Lot Size-------.�_-:_ - <br /> Water Supply: Public System and name------ ------------: =--- ------------------- :----------_---------------------- ----- Privote�r <br /> Character of soil to a depth of 3 feet: ' Sand ❑ Silt❑ -Clay ❑ , Peat ❑ 11Sandy Loam 4c--l--ay Loam ❑ <br /> [ Hardpan ❑ Adobe❑ Fill Material_--_.,__ __If yes, type__ _____________________ <br /> dI g , <br /> (Plot plan, showing size 'of lot, location of:system in relation to wells, build'iiigs, etc. must be ,placed on reverse side.) <br /> NEW INSTALLATION: (No septic"tank or seepage pit permitted if publidssewer.i-s-available within 200 feet,) t <br /> ���� r �y� f <br /> PACKAGE TREATMENT [ ] 'SEPTIC TANK "Ivl' /-t. Size-_:-�A_S _ 0�7------------------- Depth--._- <br /> --- -- <br /> Ca i l� gyT e_: '_-------Material__. - -No. Compartments-__-__ _______ ___- =•p <br /> - P, Y YP 3 � I---------------------- <br /> ---------- <br /> d <br /> 4� .L n th of each lin® ol n- Prop. Line <br /> Dis <br /> - 6 <br /> LEACHING LINE: [1�NotofcLinesnearest:-Well-__.-_ _ . g_- _ Foundation <br /> z' Length-------- �Zn________________ <br /> .�� Q <br /> � ` / <br /> I >U. Filter Material I_ �-- Depm Filter l terial-- - -P- .--:- -------- <br /> D' Z <br /> ox Type Fi . !V <br /> ``-1 `*' a r " -- MProperty-Line= <br /> Distance to nearest. Well- /. *_:_-_.___-__Foundation_ .-__ • <br /> ; <br /> SEEPAGE PIT ]+'r Depth ------- Marne _.3 _.-___Number_-___ T_-3-'------E-----_ Rock Filled Yes.�No 0-( <br /> 0 <br /> Water Table Depth. __� ---- " --- ---,--.Rock Size -- _- <br /> - ---------- --- �/ <br /> f "Distance to nearest:Well=:.____ -7� ----- -Founda't o6'410, le 1-.Prop. Line. -_.-__- <br /> - <br /> REPAIR/ADDITION {Prey. Sanitation Permit#-------------=------''-- ------:----------- ---t _.Date-- '----r `---: :----------?---------1 <br /> Septic Tank [Specify Require.lments) <br />