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NOTE: PULL AL.. RMITS (Septic, Well, etc.) MAK,.. :PIES FOR FILE <br /> I. SEWAGE: � ��,--- <br /> Distance to Public Sewers: Connection Necessary? 7 Yes No <br /> Does Existing Septic System comply with San Joaquin County Development Title ? E] Yes F-1 No Unknown <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? ❑ Yes ❑ No Is well properly sealed and constructed ? [] Yes Ej No <br /> Describe deficiency,if any: <br /> Is well system a Public Water system ? 0 Yes [—] No Is Public Water System Permit current ? E] Yes ❑ No <br /> Does existing or proposed use make this a Public Water System? 7 Yes No <br /> Is water/well sampling current? 7 Yes r-j No <br /> Additional information or comments: <br /> i <br /> 3. GARBAGE&REFUSE: <br /> Licensed scavenger pick-up? F-1 Yes ❑ 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 /> 1 <br /> r <br />"H 06 06 Report#7201 { <br /> May 16,2007 <br />