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NOTE: PULL ALL PERNxtTS (SEPTIC, WELL, ETC...) rdAKE COPIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: " Connection necessary: Yes No <br /> Does existing septic system eomply with San Joaquin County Development Title #549 ? <br /> Yes No Unknown If no, explain: <br /> Describe septic installation to be installed: 2-1410' .c I Ne, ru p o onmv A' PR4-uVr <br /> Z ,o-Dolr/owq�. A/ 5 ^Anuli �P2 <br /> 2. WATER SUPPLY: to "Ar*c,Tc <br /> Is water supplied by private well: Yes No Is well proper: Yes No <br /> State deficiency: &K rsk.+2x✓<2 rANF 1101&z wRnPASD 7o PREUEUT FRfe2�r. <br /> Is well system a Public Water system?Yes No Is the permit current?Yes_No <br /> Does existing or proposed use make this well Public Water: Yes No Is water/well <br /> sampling current: yes No Additional information or comments: <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up: Yes No Service Area No.: Other proposed <br /> disposal method: <br /> Potential problem(s): <br /> 4. FLY MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: UD Cf/96'e.' At> PKDWeLI <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: rr <br /> �I,Wton�DS/lctil^CRS — Yf}PA�V�I.H.VD 4W5'� R`Q'NaE7�-Q {c�7/PE S'g� �S EfhStL BU�� <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: A Moo D 11a ry v usT - 'Vo P#90&E <br /> 8. POPULATION DENSITY: p <br /> Approximate number of people per square mile: R k R Y1 L <br /> EH 06 06 Rev 1/99 <br />