Laserfiche WebLink
NOTE: PULL ALLMITS (Septic, Well, etc.) MAKE,,.#PIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: Connection Necessary? F—] Yes F1 No <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 ? �cs ❑ No Is well properly sealed and constructed ? ,/ 'Yes ❑ No <br /> Describe deficiency,if any; <br /> Is well system a Public Water system ? ❑ Yes 4E]'No Is Public Water System Permit current? ❑ Yes E] No <br /> Does existing or proposed use make this a Public Water System ? ❑ Yes No <br /> Is water/well sampling current ? F-1 Yes F-1 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): 1-2p-A-�- <br /> a. FLY,MOSQUITO OR VECTOR CONTROL: <br /> Describe potential Vector Control issues: <br /> 5. TOILET I 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 /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: Q� <br /> EH 06 06 Report 47201 May 11,2007 <br />