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NOTE: PULL A_ . PERMITS (Septic, Well, etc.) MAL_.-COPIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: -'-;�' Connection Necessary ? ❑ Yes ,Ef No <br /> Does Existing Septic System comply with Snn Joaquin County Development Title? 0 Yes E] No 0] Unknown <br /> If no,explain: <br /> ;Describe Septic System to be installed: <br /> 2. WATER SUPPLY: �� <br /> Is Water supplied by Private Well ? [:] Yes LJ 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 ? 0 Yes No <br /> Is water/well sampling current ? ❑ Yes ❑ No <br /> Additional information or comments: <br /> 3. GARBAGE & REFUSE: _ <br /> Licensed scavenger pick-up? EJ-Ves F-] 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/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 /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> EH 06 06 Report#7201 <br /> iY <br />