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r I �- <br /> NOTE: PULL A PERMITS (Septic, Well, etc.) MAKOPIES FOR FILE <br /> I. SEWAGE: <br /> Distance to Public Sewers: iCJ�i� Connection Necessary? Yes E2rNo <br /> Does Existing Septic System comply with San Joaquin County Development Title? Yes r-1 No Unknown <br /> If no,explain: h� <br /> Describe Septic System to be installed: <br /> ik <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well? d Yes ❑ No Is well properly sealed and constructed ? Yes No <br /> Describe deficiency,if any: <br /> Ik <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 ? F-] Yes No <br /> Is water/well sampling current? [::] Yes No ;I <br /> Additional information or comments: <br /> 1h <br /> 3. GARBAGE&REFUSE: <br /> Licensed scavenger pick-up? ET Yes ❑ No Service Area No. <br /> Other proposed disposal method: I n <br /> Potential Problem(s): <br /> �I <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: �Q,t/4;7 J_.Pf— _ G `7 �'✓ 2_ ?J <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> IIS <br /> 7. GENERAL SANITATION: <br /> List any problem(s)not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: J� ri/�lZrf� ��t/, /4M, <br /> EH 06 06 Report#7201 July 12,2005 <br />