Laserfiche WebLink
NOTE: PULL ALL MITS (Septic, Well, etc.) MAKE ,;,PIES FOR FILE µ <br /> 1. SEWAGE: <br /> Distance to Public Sewers: N��' Connection Necessary? 0 Yes ENo <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 ? EfYes ❑ No Is well properly sealed and constructed ? Yes No <br /> Describe deficiency,if any: <br /> Is well system a Public Water system ? 0 Yes No Is Public Water Sys m Permit current? Yes No <br /> Does existing or proposed use make this a Public Water System ? ED Yes LlNo <br /> Is water I well sampling current? [—] Yes F-1 No <br /> Additional information or comments: <br /> 3. GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? E-1 Yes ❑ No Service Area No. <br /> Other proposed disposal method: &I <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: "if��d — �E C�?4 , IItzo� <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: l _e� l�GcJ fYl/sl�r �✓ /� <br /> EH 06 06 Report 47201 March 14,2006 <br />