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NOTE: PULL ALIERMITS (Septic, Well, etc.) MAK PIES FOR FILE F <br /> 1. SEWAGE: <br /> Distance to Public Sewers: -� d� rNo <br /> Connection Necessary ? � Yes � <br /> Does Existing Septic System comply with San Joaquin County Development Title? Yes No Unknown <br /> If no,explain: <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 ? Q'Yes No <br /> Describe deficiency,if any: <br /> Is well system a Public Water system ? Yes Q No Is Public Water System Permit current? E] Yes No <br /> Does existing or proposed use make this a Public Water System? E] Yes ❑ No <br /> Is water/well sampling current? ❑ Yes r-1 No <br /> Additional information or comments: <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up? Q- 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 PIISTORY: <br /> 7. GENERAL SANITATION: <br /> List any problem(s) not previously noted: <br /> I 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> i <br /> July 14,2008 <br /> EH 06 06 Report#7201 <br />