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r� <br /> NOTE: PULL ALL�RMITS (Septic, Well, etc.) MAKEPIES FOR FILE <br /> 1. SEWAGE: ' <br /> Distance to Public Sewers: Connection Necessary ? No <br /> Yes ❑ <br /> Does Existing Septic System comply with San Joaquin County Development Title? ❑ Yes ❑ No n <br /> If no,explain: <br /> Describe Septic System to be installed: } <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? El Yes d No Is well properly sealed and constructed ? ❑ Yes ❑ No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system ? ❑ 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 /> Additional information or comments: <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up? N(Yes ❑ No Service Area No. <br /> Other proposed disposal method: <br /> Potential Problem(s): <br /> 4. FLY MOS UITO OR VECTOR CONTROL: <br /> Describe potential Vector Control issues: - A11 _ <br /> i <br /> 5. TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: <br /> Additional facilities required: <br /> ti. PREVIOUS OPERATION HISTORY: <br /> } <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 /> October 25,2007 <br /> :H 06 06 Report#720E <br />