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NOTE: PULL ALA -RMITS (Septic, Well, etc.) MAK .- <br /> l. SEWAGE: 1.,,0#3PIE5 FOR FILE <br /> Distance to Public Sewers: Connection Necessary ? ❑ Yes <br /> [:g/No <br /> Does Existing Septic System comply with San Joaquin County Development Title ? Eles Y <br /> If no, explain; ❑ No Unknown <br /> Describe Septic System to be installed: f <br /> 2. WATER SUPPLY. <br /> Is Water supplied by Private Well ? dYes ❑ No Is well properly sealed and constructed ? <br /> Describe deficiency,if any: dyes ❑ No <br /> Is well system a Public Water system ? ❑ Yes No Is Public Water Syst m Permit current ? ❑ Yes ❑ No <br /> Does existing or proposed use make this a Public Water System ? ❑ Yes dNo <br /> Is water/well sampling current? ❑ Yes F-1NoAdditional information or comments: <br /> 3. GARBAGE &REFUSE— <br /> Licensed scavenger pick-up? d 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 /> i <br /> List any problem(s) not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> 1 <br /> 06 06 Report#7201 <br /> April 09,2008 <br />