Laserfiche WebLink
{ <br /> NOTE: PULL ALL f,,wRMITS (Septic, Well, etc.) MAKE PIES FOR FELE <br /> I. SEWAGE: <br /> Distance to Public Sewers: Connection Necessary ? ❑ Yes ❑ No <br /> Does Existing Septic System comply with San Joaquin County Development Title ? Yes ❑ No ❑ Unknown <br /> If no, explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? [__1 Yes [—] 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 ? F1 Yes No <br /> Is water 1 well sampling current ? F] Yes F—] No <br /> Additional information or comments: <br /> 3. GARBAGE&REFUSE: <br /> Licensed scavenger pick-up? ❑ 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 /> EH 06 06 Report#7201 February 17,2009 <br /> t <br />