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NOTE: PULL ALL RMITS (Septic, Well, etc.) MAKE PIES FOR FILE <br /> 1. SEWAGE: <br /> - Distance to Public Sewers: Connection Necessary ? El Yes 0 No <br /> Does Existing Septic System comply with San Joaquin County Development Title? 0 Yes Ej No Unkno <br /> If no,explain:0 -- — <br /> ' e Septic System to be installed; <br /> WATER SUPPLY: <br /> Is Water supplied by Private Well ? ❑ Yes 0 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 ? ❑ Yes No <br /> Is water/well sampling current ? F Yes No <br /> Additional information or comments: <br /> GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? [7 Yes ❑ No Service Area No. <br /> Other proposed disposal method: <br /> Potential Problem(s): <br /> ky_'M_0SOU1T0 OR VECTOR CONTROL: <br /> Describe potential Vector Control issues: <br /> TOILET/BATH FACILITIES: - --- <br /> Number and Location(s)of existing facilities: -- - <br /> Additional facilities required: <br /> PREVIOUS OPERATION HISTORY: <br /> . GENERAL SANITATION: <br /> List any problem(s) not previously noted: <br /> POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> .06 06 Report#7201 <br />