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NOTE: PULL ALL 'RMITS (Septic, Well, etc.) MAKE (PIES FOR FILE <br /> 1. SEWAGE: � <br /> Distance to Public Sewers: A-111A Connection Necessary ? Yes O/No <br /> Does Existing Septic System comply with San Joaquin County Development Title ? EYr Yes No Unknown <br /> ff net explain: G'Gl///LcitT/GL1 ���aFf6lr�r%uG T/�t.lr� F1Q-!� •rJ� LfiZh'z�S/� <br /> i <br /> Describe Septic System to be installed: �>a _ 7 / % G'�.r7�/i,/5 .�1/6�/�//�1�.�L�-�Z'S� 4r <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well? n Yes E� No Is well properly sealed and constructed ? [�] Yes No <br /> Describe deficiency, if any: 7.�C /SGS , �/ 4//-ls=�.S��le��e'IO//,� g-A-2s Q t.� /5Zd <br /> �c�z•�Gru/�L��r9i/Y/J d /.u5¢�7tcJ <br /> Is well system a Public Water system ? F_� Yes Q No Is Public Water System Permit current? Yes D No <br /> Does existing or proposed use make this a Public Water System ? El Yes [:a No <br /> Is water/well sampling current ? F-] Yes F-1 No <br /> Additional information or comments: - <br /> 3. GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? Q/ Yes F__j No Service Area No. <br /> Other proposed disposal method: <br /> Potential Problem(s): ��l7jgt� r�ys99� -./IrT/s/ 7 ,�c -% /� ->•'Yrr�(/�r <br /> GG �eA2�s iYt4 t lUa, --A/71fLer,rZ4K 1 71 Pr/G7eaJ c�-- <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: ( - tj (tel �j/�ir�ss �f ii�3(Z/A' cL1Eb"�k� <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> List any problem(s) not previously noted 41A <br /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: �J_ q <br /> EH 06 06 Report#7201 Page 2 June 21. '_UU. <br />