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NOTE: PULL Al4' 7ERMITS (Septic, Well, etc.) MAK 40PIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: -7- �(30J Connection Necessary ? ❑ Yes jEr No <br /> Does Existing Septic System comply with San Joaquin County Development Title? Yes E] No [:14nknown <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well? es ❑ No is well properly sealed and constructed ? [2--V-es El No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system ? F-1 Yes LJ o Is Public Water System Permit current? Yes No <br /> Does existing or proposed use make this a Public Water System ? ❑ Yes ❑ No <br /> Is water/well sampling current? FI Yes n No <br /> Additional information or comments: <br /> is <br /> 3. GARBAGE&REFUSE: <br /> Licensed scavenger pick-up? F-1 Yes E] No Service Area No. <br /> Other proposed disposal method: <br /> Potential Problem(s): <br /> 4. FLY,MOSQUITO OR VECTOR CONTROL: <br /> Describe potential Vector Control issues: �� <br /> 5. TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: Z2 P <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> List any problem(s)not previously noted: <br /> i <br /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> EH 06 06 Report#17201 October 27,2009 <br />