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NOTE: PULL ALPpERMITS (Septic, Well, etc.) MAKk4OPIES FOR FILE <br /> 1. SEWAGE: F <br /> Distance to Public Sewers: Connection Necessary? El Yes No <br /> Does Existing Septic System comply with San Joaquin County Development Title? Yes F-1 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 ? 4� Yes 0 No ! <br /> Describe deficiency,if any: �� ; <br /> Is well system a Public Water system ? Yes No Is Public Water System Permit current? Yes F� No <br /> Does existing or proposed use make this a Public Water System? F-1 Yes F-� No <br /> Is water I well sampling current? ❑ Yes ❑ No <br /> Additional information or comments: <br /> 3. GARBAGE &REFUSE: <br /> Licensed scavenger pick-up? 0 Yes .,+I—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 1 BATH FACILITIES: <br /> Number and Location(s)of existing facilities: <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> / <br /> 7. GENERAL SANITATION: <br /> List any problem(s) not previously noted: �yYy <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> EH 06 06 Report#7201 June 48,2010 <br />