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NOTE: PULL ALLRMITS (Septic, Well, etc.) MAKE-"PIES FOR FILE <br /> I. SEWAGE: <br /> jDistance to Public Sewers:' Connection Necessary? ❑ Yes ,� No <br /> S <br /> Does Existing Septic System comply with San Joaquin County Development Title? Yes F1 No F1 Unknown <br /> If no, explain: <br /> Describe Septic System to be installed: <br /> i <br /> Z. WATER SUPPLY: <br /> Is Water supplied by Private Well ? Yes ❑ No Is well properly sealed and constructed ? Yes No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system ? E� Yes No 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? ❑ Yes ❑ No <br /> 1 Additional information or comments: <br /> 3. GARBAGE&REFUSE: <br /> Licensed scavenger pick-up? Yes F__j No Service Area No. <br /> Other proposed disposal method: <br /> ii Potential Problem(s): <br /> 4. FLY,MOSQUITO OR VECTOR CONTROL: <br />;i Describe potential Vector Control issues: <br /> 5. TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: s�.—��aLii <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> List any problem(s)not previously noted: <br /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> Eli 06 06 Report#7201 February 27,2009 <br />