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Permit No. .. .. ........ . <br /> e�aICATION FOR SANITATION PERMIT t <br /> (Complete in Duplicate) Date Issued - -- -----5ai <br /> P� <br /> Applica+ion 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 ith County Ordinance No.L5,449. �'Gc�?l� /,e4 r <br /> AA <br /> JOB ADDRESS AND LOCATION- --- -•--T--- ......&-�----1 -�----- fad ih� - <br /> Owner's ame--------- d 1 pts '- wD --------------------- ------------------------------------------- <br /> . Phone--- <br /> ro <br /> Address_ _ Z�— ----••-------�- ---- F <br /> Contractor's Name -'"' ------------------------- Phone-- ..�. o <br /> Installation will serve: Residence ❑ Apartment House ❑= Commercial ❑ Trailer _[ Motel� �❑ Other �r <br /> Number of living units: --- Number of bedrooms . Number of baths 3... Lot size --------------------- -- --------- <br /> _F- <br /> Water Supply: Public system ❑ Community System [:1 Private �epth to Water Table -------- ft. ' <br /> Character of sail to a depth of 3 feet: Sand F] Gravel E] Sandy Loam Clay Loam ❑ Clay F1 Adobe E] Hardpan [j <br /> Previous Application Made: Yes E] No �ew Construction: Yes �o ❑ <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> -_.(No septic tank or cesspool permitted if public sewer is available within 200 feet.)~ - `" <br /> +}� - -i <br /> Septic Ta A: Distance from nearest well Distance from.fo ndation_.Ziq—.._.---Material--... ..__-._.._.._---------- --------- <br /> p� r-- �� -Ca aci �-�'9 <br /> No, of compartments--------- ----Size�`�__6-j--- ----------------Liquid depth_v��------- ------- p tY---- -------��-��-'' <br /> Disposal Field. Distance from nearest well.'--0 _Distance trom foundation.��. ......Distance to nearest lot line.-Z-0...... <br /> P 7 !! <br /> Number of lines---- ,t....�- -..+i-nn� Length of each line <br /> -----ja.Q..-• --.Width of trench----r,2- --------------------- p, <br /> Type of filter material-__...y--- <br />