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rvR vtril-cyS�2 - <br /> APPLICATION FOR SANITATION PERMIT Permit No. .. .,� _. j <br /> ------------ ------------------------------------ (Complete in Duplicate) // l <br /> --- --------------- ------------- - _ / <br /> - - This Permit Expires Y Year From Date Issued Date Issued ._..___..��--_s!, -z,-- <br /> Application <br /> z/Application is hereby made to the San Joaquin Local Health.District for a permit to construct and install <br /> This application is made in compliance with County Ordinance No. 549. the work herein described. <br /> JOB ADDRESS AND LOCATION___ _ ____________ <br /> Owner's Namer -__._ , _7. <br /> ------------ <br /> :... <br /> •--------------- ---------•- <br /> Phone- <br /> Address............ - <br /> Contractor's Name.---__-•.- ------------------------------------------------------------•-----------•------------- Phone............... <br /> Installation will will serve: Residence ❑ Apartment House ❑ Commercial ❑ Trailer Court ❑ Motel <br /> ❑ Other <br /> Number of living units: _f0__ Number of bedrooms ./P--- Number of baths _�4___. Lot size .... <br /> '."" --. <br /> - - •--------------- -----------•-- ` <br /> Water Supply: Public system ❑ Community system ❑ Private p k <br /> �e th ro Water Table _ .__ _. ft. <br /> Character of soil fo a depth of 3 feet: Sand E] Gravel E] Sandy Loam ❑ Clay Loam ❑ Clay [Adobe❑ Hardpan ❑ <br /> Previous Application Made:;{If yes,date----------------- <br /> No New Construction: Yes ff'-No ❑ FHA/VA: Yes ❑ No Er-" <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> i n <br /> Septic Tank: Distance from nearest wellA_6__P_• ----Distance fr9m foundation__fiP_______________.Material.__ -Z(--� -� <br /> +2c <br /> No. o compartments_------0----------- Size----�. _X..__�'_-_--Liquid depth-__J__..----_--------Capacity Z 4g* -••"1 <br /> ., P tY--- <br /> Disposal Field: Distance from nearest well--:n_-------Distance from foundation----/P__�____...Distance to..nearest lot line__$��:..-_.- <br /> Number of lines--------J-----------------------Length of each line----7�-7_--------.-_---..Width of trench----'r1'-'•.-------- -_ <br /> Type of filter material._: 4� _________--.Depth of filter material__,&.`_'---- -------Total length____::'- <br /> P g <br /> See a ePit: Distance; <br />