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r ; <br /> NOTE: PULL ALL RMITS (Septic, Well, etc.) MAKE k�.. }P1ES FOR FILE <br /> 1 <br /> 1. SEWAGE: <br /> Distance to Public Sewers: 4166 Connection Necessary? Yes No 1 <br /> Does Existing Septic System comply with San Joaquin County Development Title? Yes No E] Unknown - <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well? Yes [O'Na Is well properly sealed and constructed ? Yes No <br /> Describe deficiency,if any.- <br /> Is <br /> ny:Is well system a Public Water system ? ❑ Yes F7 No Is Public Water System Permit current? Yes No <br /> Does existing or proposed use make this a Public Water System? ❑ Yes E] No <br /> Is water 1 well sampling current ? ❑ Yes' F-1 No <br /> Additional information or comments: <br /> 3. GARBAGE &REFUSE: <br /> Licensed scavenger pick-up? Yes Ej 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 /> 16114- <br /> 5. <br /> S. TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: Z—Z Q2nV <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: ^Zj"24/ <br /> Tune 20,2006 <br /> Eli 06(16 Report 47201 <br />