Laserfiche WebLink
NOTE: PULL ALLiRMITS (Septic, Well, etc.) MAKE )PIES FOR FILE <br /> I. SEWAGl1: <br /> Distance to Public Sewers: . Connection Necessary? ❑ Yes �No <br /> Does Existing Septic System comply with San Joaquin County Development Title? Yes No 0 Unknown <br /> If no, explain: <br /> Describe Septic System to be installed: <br /> a <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well? Ds No <br /> � Is well properly sealed and constructed? No <br /> Describe deficiency,if any: <br /> Is well system a Public Water system ? ❑ Yes E21 No Is Public Water System Permit current? Yes No <br /> Does existing or proposed use make this a Public Water System ? ❑ Yes ❑ No <br /> Is water 1 well sampling current? ❑ Yes ❑ No <br /> Additional information or comments: <br /> 3. GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? 0 Yes F,-,-7 1• No Service Area No. <br /> Other proposed disposal method: <br /> Potential Problem(s): <br /> 4. FLY MOS UITO OR VECTOR CONTROL: <br /> j Describe potential Vector Control issues: � a <br /> 5. TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: <br />'I 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 97201 May 29,2009 <br /> I <br />