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NOTE: PULL ALkk, ,.9RMITS (Septic, Well, etc.) MAKEmmeOPIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: Connection.Necessary? ElYes � No <br /> Does Existing Septic System comply with San Joaquin County Development Title ? Yes No E] Unknown <br /> If no,explain: efn�S _ ate.eta, � � _ raw 5- S�, n � a��r►�e- S <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well? ® Yes No Is well properly sealed and constructed ? ❑ Yes [—] No <br /> Describe deficiency,if any: �Q '&(asa' A"+ ro 5�4 /ace v-eJ. 4oJA <br /> 11101 <br /> Is well system a Public WWsystem ? Yes ❑ No Is Public Water System Permit current ? Ej Yes No <br /> Does existing or proposed use make this a Public Water System ? F-1 Yes No <br /> Is water/well sampling current? ❑ Yes No <br /> Additional information or comments: <br /> 3. GARBAGE&REFUSE: <br /> Licensed scavenger pick-up? ❑ Yes ❑ 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: <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> List any problem(s) not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> EH 06 06 Report#7201 June 01,2006 <br />